Race is Associated with Completion of Neoadjuvant Chemotherapy for Breast Cancer

Abstract

Introduction:

Completion of prescribed neoadjuvant chemotherapy (NACT) for breast cancer is paramount to patients obtaining full benefit from the treatment; however, factors affecting NACT completion are not known. We hypothesized that race is a predictor of completion of NACT in patients with breast cancer.

Methods:

All patients with breast cancer treated with NACT from 2009-2016 at a single institution were stratified by completion of NACT and by race. Univariate analysis and multivariable logistic regression were used to identify patient and tumor characteristics which affected the rate of NACT completion.

Results:

Ninety-two (74%) of 124 patients completed their prescribed NACT. On univariate analysis, white patients were more likely to complete NACT than non-white patients (76% vs 50%, p=0.006). Non-white patients were more likely to have government insurance and larger pre-chemotherapy tumors (both, p<0.05), but these factors were not associated with rates of NACT completion. After controlling for age, insurance status, tumor size, and estrogen receptor (ER) status, whites remained associated with completion of NACT (OR 3.65, p=0.014).

Conclusion:

At our institution, white patients with breast cancer were more likely than non-white patients to complete NACT. Further investigation into the underlying factors impacting this disparity is needed.