BLACK-WHITE DIFFERENCES IN SURGICAL RECEIPT IN MALE BREAST CANCER PATIENTS
Author(s)
Catherine E. Cooke, PharmD, MS, Abree Johnson, MS, MBA, Eberechukwu Onukwugha, MSc, PhD, Reuben Don, MPH, Susan Maskery, PhD, Tracie Kearns, BS, AAS, Meghan Garstka, MD.
University of Maryland, Baltimore, Baltimore, MD, USA.
University of Maryland, Baltimore, Baltimore, MD, USA.
OBJECTIVES: Despite greater incidence of male breast cancer among Black patients compared to White patients, there is limited understanding of treatment patterns. We seek to characterize the association between Black race and no surgical treatment in male breast cancer patients.
METHODS: This retrospective cohort study identified males diagnosed with Stage I to III breast cancer between 2018-2023 from the US-based National Cancer Database (NCDB). Patient demographics, clinical characteristics, and health-system variables were extracted. The primary outcome was non-receipt of surgical treatment. We estimated odds ratios and associated 95% confidence intervals using sequential logistic regression models. The crude model included only the indicator for Black race. Subsequent models sequentially added age at diagnosis, Charlson-Deyo Comorbidity Index (CCI), insurance status, and geographic location of the facility. We also investigated whether the effect of Black race varied by the geographic location of the facility.
RESULTS: In the cohort of 7,228 males with Stage I-III breast cancer, 15% were Black race, 35% were < 65 years, 72% had CCI score of zero, and 65% had Medicaid or Medicare insurance. Ninety-two percent of men received surgery. Across all models, Black race (reference White race) was positively associated with non-receipt of surgery. The effect size for Black race in the crude model was 2.2 (1.8 - 2.8) compared to 2.7 (2.1-3.4) in the fully-adjusted model. In the model with interaction terms, Black race was associated with higher odds of non-receipt of surgery at facilities in the Midwest (3.5; 2.3 - 5.3) and South (3.2; 2.3 - 4.3).
CONCLUSIONS: Black males diagnosed with breast cancer have lower odds of surgery compared to White males. The differences persisted despite adjustments for potentially confounding factors. Further investigation is needed to better understand multilevel factors that explain differences in the non-receipt of surgery in males with Stage I-III breast cancer.
METHODS: This retrospective cohort study identified males diagnosed with Stage I to III breast cancer between 2018-2023 from the US-based National Cancer Database (NCDB). Patient demographics, clinical characteristics, and health-system variables were extracted. The primary outcome was non-receipt of surgical treatment. We estimated odds ratios and associated 95% confidence intervals using sequential logistic regression models. The crude model included only the indicator for Black race. Subsequent models sequentially added age at diagnosis, Charlson-Deyo Comorbidity Index (CCI), insurance status, and geographic location of the facility. We also investigated whether the effect of Black race varied by the geographic location of the facility.
RESULTS: In the cohort of 7,228 males with Stage I-III breast cancer, 15% were Black race, 35% were < 65 years, 72% had CCI score of zero, and 65% had Medicaid or Medicare insurance. Ninety-two percent of men received surgery. Across all models, Black race (reference White race) was positively associated with non-receipt of surgery. The effect size for Black race in the crude model was 2.2 (1.8 - 2.8) compared to 2.7 (2.1-3.4) in the fully-adjusted model. In the model with interaction terms, Black race was associated with higher odds of non-receipt of surgery at facilities in the Midwest (3.5; 2.3 - 5.3) and South (3.2; 2.3 - 4.3).
CONCLUSIONS: Black males diagnosed with breast cancer have lower odds of surgery compared to White males. The differences persisted despite adjustments for potentially confounding factors. Further investigation is needed to better understand multilevel factors that explain differences in the non-receipt of surgery in males with Stage I-III breast cancer.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HSD63
Topic
Health Policy & Regulatory, Health Service Delivery & Process of Care
Disease
Oncology