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MBC Applying New Developments

CE / CME

Applying the Latest Developments in Metastatic Breast Cancer Through Education of Healthcare Professionals, Patients, and Caregivers

Nurses: 1.50 Nursing contact hours

Physicians: maximum of 1.50 AMA PRA Category 1 Credits™

Pharmacists: 1.50 contact hours (0.15 CEUs)

Released: October 19, 2023

Expiration: October 18, 2024

Joyce O'Shaughnessy
Joyce O'Shaughnessy, MD
CME/CE Information

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MBC: Disease Overview

I would like to begin with a brief overview of MBC, including what we know about its demographics and—of most importance—the key management strategies we currently employ. I hope to provide you with a good overview of the state-of-the-art treatments that we want to implement in the clinic for our patients with MBC.

Unfortunately, breast cancer is very common. In the United States, approximately 300,000 new cases are expected in 2023, along with approximately 43,000 patient deaths.1 Women who die of breast cancer typically have experienced progression to the metastatic phase. As we will discuss in this module, the treatment of MBC is becoming increasingly complex given the growing number of therapies and individualized treatment. 

Unfortunately, health disparities exist in the care of women with breast cancer. Despite a lower incidence of breast cancer in non-Hispanic Black women vs non-Hispanic White women, non-Hispanic Black women in the United States are 40% more likely to die from their disease.2 Important questions surrounding that disparity include how much of that is driven by worse disease biology vs social determinants of health. In addition to comorbidities, socioeconomic factors such as limited education, low disease awareness, how quickly patients can access care, and life situations or limited economic resources that can lead to challenges in a patient’s ability to continue or complete therapy all can get in the way of optimal care for women with breast cancer.3 

 A useful handout to help inform patients about important questions to ask, what to expect, available resources, and other important reminders in the form of a communication checklist can be found here.

Incidence and Mortality Rates in Women with Metastatic Breast Cancer

We know that delays in treating MBC contribute to poorer outcomes in patients. The chart on the left shows the disproportionate incidence and mortality rates in the non-Hispanic Black population compared with the other populations.4 This also is reflected in the graphs in the middle of the slide when broken down by age group, which suggests that Black race and older age are substantially correlated with increased incidence and mortality from breast cancer.4

The sooner we can start treatment in a patient with biopsy-proven MBC, the better the outcomes. Conversely, substantial delays in initiating therapy potentially can translate into worse overall outcomes.

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Proposals for Addressing Equity Challenges in MBC Care

Addressing equity challenges across underserved patient populations is a very important consideration to ensure fair access to care. This table provides a framework that details various challenges currently affecting underserved patients and how healthcare professionals, policymakers, and patient advocacy groups can help support patients to overcome these barriers.3 For example, to improve awareness and tailor management approaches to support underserved patients with MBC, healthcare professionals can measure outcomes for patients from different cultural groups, policymakers can provide a clear picture of the local and national issues via evaluation of metrics, and patient advocacy groups can advise on issues to ensure that educational content is appropriate and help drive uptake.

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