Abstract B018: Exploring racial disparities in breast reconstruction after mastectomy at an NCI-Designated Cancer Center
Authors: Connors Shahnjayla K. , Goodman Melody G. , Myckatyn Terence , Margenthaler Julie , Gehlert Sarah 
Published: August 2020

Abstract
Introduction: Breast reconstruction after mastectomy is an important component of comprehensive breast cancer care due to its positive effects on quality of life for breast cancer survivors. Yet, African American women are significantly less likely to receive breast reconstruction compared to Caucasian women. Due to the positive impact breast reconstruction has on quality of life in breast cancer patients, these disparities have implications for survivorship in African American women who already bear the excess burden of breast cancer mortality. We previously reported the presence of breast reconstruction disparities at Siteman Cancer Center, a large, urban National Cancer Institute-designated Comprehensive Cancer Center located in St. Louis, Missouri. The purpose of this study was to further understand these disparities by assessing breast reconstruction rates, patterns, and predictors by race.
Methods: Sociodemographic, clinical, and treatment data were obtained for women who received mastectomy for definitive surgical treatment for breast cancer from 2000 to 2012. Statistical tests were used to compare the data between African American and Caucasian women. Logistic regression was used to identify significant predictors of breast reconstruction stratified by race.
Results: African American women had significantly higher proportions of public insurance, more aggressive tumors, unilateral mastectomies, and modified radical mastectomies. These are characteristics that reduce the odds of receiving breast reconstruction. African American women had a significantly lower breast reconstruction rate and higher proportion of autologous-based breast reconstruction, which has higher complication rates than implant-based breast reconstruction. Adjuvant radiation was a significant predictor in Caucasian, but not in African American women.
Conclusion: African American and Caucasian women varied in rate and type of breast reconstruction. These disparities may be due to racial differences in sociodemographic, clinical, and treatment factors. Additionally, since the predictors of breast reconstruction varied by race, the underlying mechanisms for the receipt of breast reconstruction may vary in African American women. Future research should focus on further examining the determinants of the breast reconstruction, by modality, and the role breast reconstruction disparities play in clinical outcomes and quality of life in African American women.
Citation Format: Shahnjayla K. Connors, Melody G. Goodman, Terence Myckatyn, Julie Margenthaler, Sarah Gehlert. Exploring racial disparities in breast reconstruction after mastectomy at an NCI-Designated Cancer Center [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B018.