OBJECTIVES: Breast cancer, the most common type of cancer and the second leading cause of cancer death among women in the United Sates, affects different racial/ethnic groups variedly in terms of diagnosis, treatment and survival. Despite the increased number of women living with breast cancer, black women in Louisiana continue to have the highest breast cancer mortality rates. This study aimed to assess the utilization of follow-up care among work-age female breast cancer survivors in Louisiana and investigate racial/ethnic disparities in relevant care.

METHODS: A retrospective cohort study was conducted using electronic medical records (EMRs) obtained from REACHnet (Research Action for Health Network) partners and data from the Louisiana Tumor Registry (LTR). Work-age (18-64 years old) women with first primary stage I-III breast cancer from 2013-2018 were included. Preliminary results on the differences in characteristics of the study population and use pattern of first course treatments (chemotherapy, hormone therapy and immunotherapy) between racial/ethnic groups were reported.

RESULTS: 890 non-Hispanic black (age: mean=51.19; standard deviation =8.80) and 999 non-Hispanic white (age: mean=52.54; standard deviation=8.70) female patients were identified using crosswalk that matched eligible patients from two databases. More black patients (33.71% vs 19.92%) were covered by Medicaid, and more white patients had private insurance (56.96% vs 35.62%; p<0.0001). Black women were less likely to have Stage I diagnosis (42.13% vs 52.45 %, p<0.0001). Black women were also less likely to receive hormone therapy (44.38% vs 60.96%, p<0.0001), but more likely to receive chemotherapy (68.43% vs 56.66%, p<0.0001). No significant difference was found in immunotherapy. These differences showed similar patterns in logistic regression models controlling for age, insurance type and stage, as well as among Stage I patients from subgroup analyses.

CONCLUSIONS: Racial/ethnic disparities in diagnosis and first-course treatments were observed among work-age women with early-stage breast cancer in Louisiana.