Examining a decade of racial disparity in partial mastectomy and oncoplastic surgery

J Surg Oncol. 2023 Mar;127(4):541-549. doi: 10.1002/jso.27173. Epub 2022 Dec 12.

Abstract

Background and objectives: Understanding racial disparity is crucial to addressing health equity and access to care. Our study aims to examine racial differences in breast conserving surgery (BCS) utilization rates and determine how these rates have changed over time.

Methods: This retrospective cohort analysis utilized the NSQIP database to identify women diagnosed with breast cancer who underwent BCS procedures between 2008 and 2019. Racial utilization trends were analyzed using a Cochran-Armitage test and Index of Disparity analysis.

Results: In the 12-year period, 202 492 women underwent a breast cancer surgery, of which 47% underwent BCS. Within the BCS subgroup, oncoplastic surgery utilization increased from 3% to 10%, leading to a declining proportion of partial mastectomies: 97% to 90.0% (both p < 0.01). The racial index of disparity for overall BCS patients decreased from 7% to 6%, remained unchanged (1%) for partial mastectomies, and significantly decreased in oncoplastics (23%-7.6%).

Conclusion: BCS represents a mainstay option for early-staged breast cancer interventions, this study demonstrate promising progress in decreasing the index of disparity among races and persistent racial inequalities.

Keywords: breast cancer surgery; oncoplastic surgery; partial mastectomy; racial disparity; utilization rates.

MeSH terms

  • Breast / surgery
  • Breast Neoplasms* / surgery
  • Female
  • Humans
  • Mammaplasty*
  • Mastectomy
  • Mastectomy, Segmental / methods
  • Retrospective Studies