Healthcare Use According to Breast Cancer Subtype in Early Breast Cancer: A Patient-Level Data Analysis in Taiwan

OBJECTIVES: This study explored the relationship of healthcare use (HCU) within the first 2 years after diagnosis of early breast cancer (BC) subtype in Taiwan, using patient-level data.

METHODS: This non-interventional study used retrospective clinical patient chart data from early BC patients diagnosed between 2018-2021 from Linkou Chang-Gung Memorial Hospital, Taiwan. Data pertained to patient profiles, treatment patterns, and healthcare use within first 2 years post-diagnosis. Adjusted odds-ratio (aOR) and 95% confidence interval (CI) were computed using logistic regression to quantify the association between tumor subtype (human epidermal growth factor-2-positive [HER2+], HER2-negative/hormone receptor-positive [HER2-/HR+], triple-negative breast cancer [TNBC]), and HCU.

RESULTS: Data of 1719 early BC patients were analyzed, with 67.4% having HER2-/HR+ subtype (HER2+: 23.7%; TNBC: 8.9%). A higher proportion of early BC patients had stage 2 cancer (HER2-/HR+: 48.5%; HER2+: 59.2%; TNBC: 61.4%), lymph node negative (71.4%; 56.5%; 61.4%), had breast conserving surgery (68.9%; 60.2%; 69.3%), did not have neoadjuvant treatment (82.3%; 60.9%; 52.3%) and had adjuvant treatment (95.8%; 92.9%; 72.6%). Compared with HER2-/HR+ patients, HER2+ and TNBC subtypes were more likely to have neoadjuvant treatment (aOR [95% CI], HER2+: 2.51 [1.89-3.33]; TNBC: 4.78 [3.17-7.20]), ≥37 outpatient visits (2.39 [1.85-3.10]; 2.00 [1.36-2.94]), ≥8 hospitalizations (3.53 [2.67-4.65]; 4.06 [2.67-6.18]), and longer hospitalization stay of ≥14 days (3.61 [2.77-4.71]; 2.29 [1.52-3.44]); but were less likely to have adjuvant treatment (0.56 [0.34-0.91]; 0.12 [0.07-0.19]) within 2-years’ post-diagnosis (all p<0.05). When comparing healthcare use, HER2+ was more likely than TNBC to have higher outpatient and emergency department visits and longer hospitalization stays.

CONCLUSIONS: The HCU in early BC care within the first 2-years’ post-diagnosis was mainly driven by the tumor subtype with higher utilization associated with HER2+. These data implied a need for efforts to address the potential healthcare burden for early breast cancer in Taiwan.