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Abstract A1: Race has no impact on breast cancer outcome: Results of 803 patients treated at a public hospital

Introduction: African-American women (AA) have a lower incidence of breast cancer, yet a higher breast cancer mortality rate than Caucasian women (C). Whether the mortality differences are the result of more aggressive tumors in AA women or the effect of differences in socioeconomic status (SES) is debatable. A clearer understanding of the role of race requires SES to be controlled as a potential confounder, which can be achieved by evaluating outcome within a population with a high proportion of uninsured patients. Our state-run academic medical center serves as a healthcare safety net for the 715,000 uninsured residents of Louisiana. We provide compelling evidence that race is not predictive of outcome for patients with operable breast cancer. Methods: From our prospective breast cancer database which has been maintained since 1998, we examined the data for all 803 patients with stage 0 to 3 breast cancer. All patients received standard definitive surgical care as well as appropriate adjuvant treatment. Study homogeneity was maintained by standardized treatment, surveillance, and compliance protocols. Primary endpoints were cancer recurrence and death. Statistical analysis performed included Kaplan-Meier survival analysis, log-rank test, Cox proportional hazard model, independent samples t-test, and chi-square test. A p-value ≤ 0.05 was considered statistically significant. Results: Sixty percent of patients were AA (N= 479 patients) and the mean follow-up time for AA and C patients was 58 months. Almost 70% of patients were classified as either free care or Medicaid. There were no significant differences in tumor size (p=0.83), nodal distribution (p=0.74), stage distribution (p=0.88), or definitive surgery performed (p=0.32) between the races. However, AA tend to be younger (p=0.003) with a higher tumor grade (p Conclusion: In a predominantly indigent population, race had no impact on breast cancer outcome. Hence, women who were treated at our academic center with a public hospital can expect to have breast cancer outcome rivaling those reported in the literature. Further study is needed to understand the elements involved in our success.