Abstract PS4-09-30: Mapping Inequity: Racial Variations in Breast Cancer Hospital Admissions and Clinical Outcomes in the U.S

Abstract Introduction: Race may affect the clinical outcomes in breast cancer. We aimed to identify how race impacts admission, clinical outcomes, and disposition of breast cancer patients. Methods: We performed a retrospective analysis of breast cancer-related hospital admissions using the 2022 National Inpatient Sample (NIS). Patients were stratified according to race into the following groups: White, African American, Hispanic, Asian or Pacific Islander, Native American, and Other. The data analysis was performed using STATA/BE version 18.5. ANOVA, Chi-square, and multivariate logistic regression analysis were performed to evaluate the impact of race on the clinical outcome of the study population. Results: In 2022, there were 33,597 hospitalizations for breast cancer in the United States; of these, 64.7% were White, 16.7% African-American, 11.1% Hispanic, 3.7% Asian/Pacific Islander, 0.4% Native American, and 2.7% Other. The average age at breast cancer hospitalization showed significant racial differences, with means of 67 years for Whites, 62 years for African-Americans, 60 years for Hispanics, 61 years for Asian/Pacific Islanders and Others, and 59 years for Native Americans (p < 0.001). In-hospital mortality rates for breast cancer differed significantly by race, ranging from 5.0% in Whites to 6.0% in African-Americans (p = 0.02). Regarding the in-hospital outcomes with comparsion to White patients, African-Americans had substantially higher odds of AKI (OR = 1.42, p < 0.001), while patients categorized as "Other" had significantly lower odds (OR = 0.82, p = 0.046); no significant differences were observed for Hispanics, Asian/Pacific Islanders, or Native Americans. Referencing Whites, African-Americans had significantly higher odds of pulmonary embolism (OR = 1.27, p < 0.001), whereas Hispanics (OR = 0.79, p = 0.004), Asian/Pacific Islanders (OR = 0.53, p < 0.001), Native Americans (OR = 0.29, p = 0.036), and Others (OR = 0.68, p = 0.018) had significantly lower odds. The distribution of hospital teaching status varied by race, with the majority of African-American, Hispanic, and Asian/Pacific Islander receiving care at teaching hospitals (over 83%), compared to 76.6% of White patients and 73.4% of Native Americans; non-teaching hospital admissions were highest among Native Americans (26.6%) and Whites (25.4%). Hospital region varied significantly by race (p < 0.001), with most African-American patients admitted in the South (54.2%), Whites primarily in the South (36.1%) and Midwest (24.8%), and Asians/Pacific Islanders predominantly in the West (50.5%). Median household income also differed by race (p < 0.001), with nearly half of African-American patients (46.7%) in the lowest income quartile, compared to 20.6% of Whites and 49.6% of Asians/Pacific Islanders in the third quartile. Discharge disposition showed racial variation (p < 0.001), with Hispanics and Asians/Pacific Islanders more often discharged home (60.2% and 58.0%, respectively) compared to Whites and African-Americans (∼49.5%). Insurance status differed significantly (p < 0.001); Medicare coverage was highest among Whites (63.6%), while Medicaid was more common in African-Americans (19.7%) and Hispanics (27.2%), and private insurance predominated among Asians/Pacific Islanders (37.8%). Conclusion: Significant racial disparities exist in breast cancer hospitalizations across the United States, affecting patient age, outcomes, comorbidities, and healthcare access. African-American patients experience higher risks of complications such as AKI and pulmonary embolism and are more likely to be treated in teaching hospitals and lower-income regions. These findings highlight the need for targeted interventions to address racial inequities in breast cancer care and outcomes. Citation Format: T. A. Mathew, A. Al Sharie, M. Gevorgian, B. Easow, S. Valasareddi. Mapping Inequity: Racial Variations in Breast Cancer Hospital Admissions and Clinical Outcomes in the U.S. [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS4-09-30.