The Effect of Insurance and Race on Breast Cancer Tumor Biology and Short-Term Outcomes

Author:

Samiian Laila1,Sharma Priya1,Botty Van Den Bruele Astrid1,Smotherman Carmen2,Vincent Mia1,Crandall Marie1

Affiliation:

1. Department of Surgery, University of Florida College of Medicine, Jacksonville, Jacksonville, Florida and

2. Center for Health Equity and Quality Research (CHEQR), University of Florida, Jacksonville, Florida

Abstract

To determine whether low-income status as demonstrated by insurance type has any association with aggressive tumor biology and breast cancer outcomes. Retrospective review of 535 women with new diagnosis of breast cancer from January 2009 to March 2013 was performed. There was no significant association between race and stage at diagnosis. Women with Medicaid/Charity coverage were diagnosed at more advanced stages, more likely to have triple-negative breast cancer (TNBC), and had longer time to treatment. Rate of TNBC was higher in black women and younger patients. There was no significant difference in breast cancer recurrence or survival by race, insurance type, age, or tumor biology. In multivariable analysis, only black race (P = 0.003) and Medicaid/Charity Insurance (P = 0.0008) were the most significant predictors of TNBC. Presentation of aggressive tumor biology and advanced stage is strongly associated with socio-economic factors as reflected by Medicaid funding and lack of insurance.

Publisher

SAGE Publications

Subject

General Medicine

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