Roth Jacquelyn, Yu Bernice Z, Godek Maxwell, Fung Ethan, Barrow Brooke, Taub Peter J, Henderson Peter W
Icahn School of Medicine at Mount Sinai Hospital, New York, NY 10029, USA.
J Clin Med. 2025 Sep 17;14(18):6532. doi: 10.3390/jcm14186532.
While higher complication rates among minority patients following breast reconstruction are documented, the role of lengthier care intervals in perpetuating these disparities remains unclear. This study assesses whether race influences the timeliness of breast reconstructive care for patients following breast cancer diagnoses. A retrospective analysis of breast reconstruction patients between 2017 and 2023 was conducted. Primary outcomes comprised intervals from breast cancer diagnosis to plastic and reconstructive surgery (PRS) consultation, index reconstructive procedure, and final reconstructive procedure. Regression models assessed the impact of race on outcomes. Of the 1662 patients included, 745 identified as White (44.8%), 337 as Black (20.3%), 199 as Asian (12.0%), 278 as "Other" races (16.7%), and 103 did not specify race (6.2%). Baseline characteristics differed significantly across groups ( < 0.001). Latino patients comprised the majority of the 'Other' (50%) and 'Unknown' (75%) race categories. On multivariable regression, intervals to PRS consultation and index procedure were significantly prolonged for Black (β = 0.307, = 0.001 and β = 0.254, < 0.001, respectively) and "Other" race (β = 0.332, = 0.006 and β = 0.283, = 0.001) patients, while Black patients also faced significantly longer intervals to the final procedure (β = 0.213, = 0.001). Prolonged care intervals for non-White patients persist at multiple stages of breast reconstruction, potentially exacerbating outcome disparities. The present study implicates logistical barriers such as fragmented care, scheduling, and transportation challenges, as well as provider- or patient-level bias, as contributors to race-based disparities in timely care.
虽然有记录表明少数族裔患者在乳房重建后的并发症发生率较高,但较长的护理间隔时间在加剧这些差异方面所起的作用仍不明确。本研究评估种族是否会影响乳腺癌确诊患者乳房重建护理的及时性。对2017年至2023年间的乳房重建患者进行了回顾性分析。主要结局包括从乳腺癌诊断到整形与重建手术(PRS)会诊、初次重建手术以及最终重建手术的间隔时间。回归模型评估了种族对结局的影响。在纳入的1662名患者中,745名认定为白人(44.8%),337名认定为黑人(20.3%),199名认定为亚洲人(12.0%),278名认定为“其他”种族(16.7%),103名未注明种族(6.2%)。各组的基线特征存在显著差异(<0.001)。拉丁裔患者在“其他”(50%)和“未知”(75%)种族类别中占多数。在多变量回归分析中,黑人患者(β = 0.307,P = 0.001;β = 0.254,P < 0.001)和“其他”种族患者(β = 0.332,P = 0.006;β = 0.283,P = 0.001)到PRS会诊和初次手术的间隔时间显著延长,而黑人患者到最终手术的间隔时间也显著更长(β = 0.213,P = 0.001)。非白人患者在乳房重建的多个阶段护理间隔时间都较长,这可能会加剧结局差异。本研究表明,诸如护理分散、安排和交通挑战等后勤障碍,以及提供者或患者层面的偏见,是导致及时护理中基于种族的差异的因素。