Disparities in Palliative Care Utilization in Metastatic Triple-negative Breast Cancer: A National Cancer Database Study.
Only 19.5% of patients with metastatic triple-negative breast cancer received palliative care.
Disparities in Palliative Care Utilization in Metastatic Triple-negative Breast Cancer: A National Cancer Database Study.
Metastatic triple-negative breast cancer (triple-negative breast cancer) is characterized by an aggressive clinical course and poor prognosis relative to other breast cancer subtypes.
This study examined the sociodemographic, policy, and facility-level factors associated with palliative care utilization in metastatic triple-negative breast cancer.
Adults with metastatic triple-negative breast cancer (2018-2023) were identified from the National Cancer Database.
About 1 in 5 eligible patients actually received palliative care.
Medicaid-expansion states were associated with higher palliative care utilization [adjusted odds ratios (aORs)=1.39-1.83 across expansion timing categories; all p <0.05].
Uninsured patients had higher odds of palliative care utilization than privately insured patients [aOR=1.53, 95% confidence interval (CI)=1.14-2.07; p =0.005].
Treatment at academic/research programs was associated with higher palliative care utilization than community cancer centers (aOR=1.31, 95%CI=1.01-1.71; p =0.041).
Geographic variation was observed, with higher odds of palliative care utilization in the Northeast, South, and Midwest than the West (all p <0.05).
In this largest population-level study to date, we found that palliative care utilization remains low among patients with metastatic triple-negative breast cancer, and was associated with insurance coverage, facility type, and geographic region.
These findings highlight disparities in access to palliative care and underscore the need for more equitable and timely integration of palliative care among patients with metastatic triple-negative breast cancer.