Background: Race and ethnicity are important factors that impact access to and surgical outcomes following breast-conserving therapy (BCT). Studies suggest that minority patients undergo BCT at lower rates and experience increased rates of postoperative complications. There is, however, limited research assessing racial and ethnic disparities in patient-reported outcomes (PROs) following BCT. Thus, the purpose of this study was to examine the impact of race and ethnicity on BREAST-Q scores following BCT.
Methods: Female patients who underwent BCT between January 2017 and October 2022 were included in this study. Patients were grouped as those who identified as White, Black, Asian, or Hispanic of any race. Satisfaction with Breasts (SWB), Physical Well-being of the Chest (PWBC), Psychosocial Well-being (PWB), and Sexual Well-being (SEX) were examined preoperatively and 6 months, 1-year, and 2-years postoperatively. Accounting for demographic and treatment related details, multivariable generalized estimating equation models were fit for the BREAST-Q domains. Statistical significance was set as a p-value<0.05, and a difference of ? 4 between scores was considered the minimal clinically important difference (MCID).
Results: 5,480 patients met inclusion criteria. 567 (10.3%) were Asian, 453 (8.3%) were Black, and 431 (7.9%) were Hispanic. Following multivariable analysis, identifying as Black (?=-6.5, 95% Confidence Interval: -8.1, -5.0, p<0.001) or Hispanic (?=-7.9, 95% Confidence Interval: -9.4, -6.4, p<0.001) was statistically and clinically associated with lower PWBC scores than White race. Clinically and statistically significant difference was found between the SEX scores of Asian (?=-5.5, 95% Confidence Interval: -7.2, -3.8, p<0.001) and White patients.
Conclusion: Compared to White patients, minority patients report significantly lower BREAST-Q scores. There exist disparities in PROs for minority patients, and this study underscores the importance of addressing the root of these differences in bettering care for these patient populations.
