• Bridget A Oppong, Oindrila Bhattacharyya, Yaming Li, Samilia Obeng-Gyasi, and Vanessa B Sheppard.
• Division of Surgical Oncology, Department of Surgery, The Ohio State University, Columbus, OH, USA. Electronic address: bridget.oppong@osumc.edu.
• J Natl Med Assoc. 2022 Jun 1; 114 (3): 298-307.

BackgroundBreast conservation surgery (BCS) and mastectomy have equivalent survivability. However, perception of surgical benefit may be affected by breast cancer subtypes, impacting procedure choice. We evaluate surgical management among non-Hispanic Black (NHB) and White (NHW) breast cancer patients based on subtypes.MethodsQueried the National Cancer Database (NCDB) including BCS eligible women with T1 (<2cm) breast cancer between 2011 and 2016. We selected NHB and NHW women and evaluated differences in sociodemographic variables and treatment including surgery. To determine factors associated with receipt of BCS, a multivariable logistic regression analysis was performed adjusting for age, race, surgery type and breast cancer subtypes.ResultsAnalyzed 390,278 women with 89.7% NHW and 10.3% NHB, of mean age 63 years. 55.4% vs. 53.5% of NHW compared to NHB women had BCS (p<.001) as initial cancer therapy. Statistically significant differences between NHB and NHW in surgery were found on univariate analysis in all breast cancer subtypes except Luminal B. NHB women with TNBC and Luminal A subtypes were more likely to undergo BCS on multivariate analysis.ConclusionsSignificant differences are found in the surgical management of breast cancer with Black women more likely to receive BCS, less likely to undergo mastectomy compared to White counterparts even with TNBC or her-2+ subtypes. Understanding surgical decision making and how knowledge of subtype is applied deserves further study in women of diverse racial and ethnic groups.Copyright © 2022 National Medical Association. Published by Elsevier Inc. All rights reserved.

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