OBJECTIVES: Care for breast cancer, the second most common cancer among US women, has varied by race. The COVID-19 pandemic further highlighted racial disparities in general healthcare access and outcomes. This study aimed to describe breast cancer-related healthcare resource utilization (bcHCRU) and initial breast cancer staging of adult females by race pre- and post-COVID-19 to identify possible changes in care.

METHODS: This retrospective claims cohort study used the Komodo Research Dataset from August 2018 through May 2023. Adult females with their first breast cancer diagnosis (index) between February-July 2019 (pre-COVID-19 cohort) or July-November 2022 (post-COVID-19 cohort) were included with no prior observable breast cancer diagnosis. Patients had medical and pharmacy continuous enrollment for >6 months before (baseline) and after index (follow-up) and a second breast cancer diagnosis during follow-up. Patient characteristics and bcHCRU, defined as a claim with a coexisting breast cancer diagnosis, were described by cohort and race.

RESULTS: 10,095 White (mean age 62.1 years) and 2,217 Black (60.9 years) pre-COVID-19 patients and 7,272 (60.1 years) and 1,933 (57.9 years) post-COVID-19 patients were identified. 21.2% and 26.6% of White and Black pre-COVID-19 patients and 23.8% and 27.9% of post-COVID-19 patients, respectively, had metastatic breast cancer at initial diagnosis. 10.0% and 13.6% of White and Black pre-COVID-19 patients and 8.7% and 12.7% of post-COVID-19 patients, respectively, had >1 bc-related inpatient admission. 8.1% and 13.1% of White and Black pre-COVID-19 patients and 8.6% and 14.5% of post-COVID-19 patients, respectively, had >1 bc-related ER visit.

CONCLUSIONS: Differences in breast cancer care by race were consistent pre- and post-COVID-19 and must be addressed. Additional comparative research should be conducted to assess these racial disparities further.