Abstract PS4-12-11: Covid-19 and breast cancer disparities: were our fears realized?

Abstract Background: Black women historically present with more advanced stages of breast cancer (BC) and experience 40% higher mortality than White women. The COVID-19 pandemic strained healthcare systems and reduced access to routine care, including screening. These disruptions raised concerns about widening racial disparities in BC diagnosis and treatment. We previously found no significant worsening in stage at diagnosis during the pandemic. Here, we evaluate racial differences in time to first definitive treatment and treatment outcomes before and during the pandemic. Methods: We conducted a retrospective cohort study of self-identified Black and White women aged 18+ diagnosed with invasive BC at a large comprehensive breast center between January 2018 and December 2021. We defined “pre-COVID” as 2018-2019 and “mid-COVID” as 2020-2021. Demographic, clinical, and tumor characteristics, including receptor status (ER, PR, HER2) and clinical stage (AJCC 8), were abstracted from the electronic medical record. Clinical stage was grouped into early (Stage I/II) vs. late (Stage III/IV). Time to first definitive treatment (surgery or chemotherapy) was calculated from diagnosis, with delay defined as >60 days. Neighborhood-level social vulnerability was derived from census tract data. Chi-square, Wilcoxon, and logistic regression analyses were used to assess associations by race and time period. Results: Of 3,399 patients, 10.4% were Black and 89.6% White. Black patients were more likely to live in urban areas (61.3% vs. 13.7%, p