Palliative Care Displays Low Utilization in Metastatic Breast Cancer

The utilization of palliative care shows low occurrence for patients with de novo metastatic breast cancer (dnMBC) alongside a lack of fairness in racial/ethnic patient populations, according to a study presented at the 2023 ASCO Quality Care Symposium.

Palliative care can improve quality of life in advanced cancers though its use is lacking in the United States, according to study authors.

The objective of the study was to analyze the use of palliative care across patient populations based on sex and race/ethnicity. Another objective within the study was to investigate disparities based by sex in correlating to palliative care utilization.

Researchers analyzed data from 2004-2019 uploaded into the National Cancer Database (NCDB) for patients with de novo metastatic breast cancer. Palliative care including surgery, radiotherapy, systematic therapy and/or pain management were implemented to detect pain, symptoms and side effects (categorized as a ‘yes’ or ‘no’ when it came to categorization) in correlation with the NCDB.

The patient populations that were evaluated were based on non-Hispanic (NH), Asian, NH Black, Hispanic and NH White groups. Sex was reported as either male or female when evaluation was in process. Repetitive trends and patterns seen in the low utilization of palliative care wasobserved for future analyzation. Observing ethnic/racial disparities based on palliative care was also analyzed, stratified by sex.

According to The University of Chicago Department of Public Health Sciences, one in five patients use palliative care generally and by sex. Although palliative care had increased from 2004 to 2019, utilizationcontinued to remain low within female and male patients. Patients with racial/ethnic minoritieswere less likely toutilize palliative care than White patients, regardless of sex.

Results of the study showed that within the group of 134,943 patients who participated in the evaluation of palliative care, (median age being 62 years old) 98.6% were female. A majority of the patient population, 74.1%, were Non-Hispanic White, with 17.2% being Non-Hispanic Black, 5.9% being Hispanic and 2.7% being Non-Hispanic Asian.

A total of 20.3% of the patient population received palliative care services, which represented a 15.6% increase from the span of 2004 to 2005 compared with a 24.6% increase from 2018 to 2019.

When it comes to sex, 20.3% of females within the study used palliative care, which increased from 15.7% in 2004 to 2005 compared with 24.6% from 2018 to 2019. The male patient population, about 20.2%, used palliative care, which increased from 12.7% in 2004 to 2005 compared to 24.1% in 2018 to 2019.

The study had concluded that there was a low representation of palliative care for patients with de novo metastatic breast cancer., although there were signs of increase utilization from 2004 to 2005 and 2018 to 2019. Ethnic/racial disparities were highlighted immensely and represented within the study.

Supportive care programs should begin to focus on providing palliative care to the patient population of de novo metastatic breast cancer, according to the researchers of the study. 

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