Breast cancer mortality in African-American and non-Hispanic white women by molecular subtype and stage at diagnosis: a population-based study

Details

• Alternative Title:
  Cancer Epidemiol Biomarkers Prev
• Personal Author:
  Tao, Li ; Gomez, Scarlett Lin ; Keegan, Theresa HM ; Kurian, Allison W. ; Clarke, Christina A.
• Description:
  Background ; Higher breast cancer mortality rates for African-American than non-Hispanic white women are well documented; however, it remains uncertain if this disparity occurs in disease subgroups defined by tumor molecular markers and stage at diagnosis. We examined racial differences in outcome according to subtype and stage in a diverse, population-based series of 103,498 patients. ; Methods ; We obtained data for all invasive breast cancers diagnosed 1/1/2005-12/31/2012 and followed through 12/31/2012 among 93,760 non-Hispanic white and 9,738 African-American women in California. Molecular subtypes were categorized according to tumor expression of hormone receptor (HR, based on estrogen and progesterone receptors) and human epidermal growth factor receptor 2 (HER2). Cox proportional hazards models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for breast cancer-specific mortality. ; Results ; After adjustment for patient, tumor and treatment characteristics, outcomes were comparable by race for Stage I or IV cancer regardless of subtype, and HR+/HER2+ or HR-/HER2+ cancer regardless of stage. We found substantially higher hazards of breast cancer death among African-American women with Stage II/III HR+/HER2- (HR, 1.31, 95% CI, 1.03-1.65, and HR, 1.39, 95% CI, 1.10-1.75, respectively) and Stage III triple-negative cancers relative to whites. ; Conclusions ; There are substantial racial/ethnic disparities among patients with Stages II/III HR+/HER2- and Stage III triple-negative breast cancers but not for other subtype and stage. ; Impact ; These data provide insights to assess barriers to targeted treatment (e.g. trastuzumab or endocrine therapy) of particular subtypes of breast cancer among African-American patients.
• Subjects:
  • Black or African American
  • Age Factors
  • Aged
  • Biomarkers, Tumor
  • Breast Neoplasms
  • White People
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Staging
  More +
• Source:
  Cancer Epidemiol Biomarkers Prev. 24(7):1039-1045.
• Pubmed ID:
  25969506
• Pubmed Central ID:
  PMC4490947
• Document Type:
  Journal Article
• Funding:
  HHSN261201000140C/CA/NCI NIH HHS/United States ; HHSN261201000035C/CA/NCI NIH HHS/United States ; HHSN261201000036C/CA/NCI NIH HHS/United States ; HHSN261201000010C/CA/NCI NIH HHS/United States ; U58 DP000807/DP/NCCDPHP CDC HHS/United States ; HHSN261201000035I/CA/NCI NIH HHS/United States ; HHSN261201000034C/CA/NCI NIH HHS/United States ; HHSN261201000040C/CA/NCI NIH HHS/United States ; HHSN261201000040I/CA/NCI NIH HHS/United States
• Place as Subject:
  United States
• Volume:
  24
• Issue:
  7
• Download URL:
  https://stacks.cdc.gov/view/cdc/42052/cdc_42052_DS1.pdf
• File Type:
  [PDF - 212.69 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:f0886d74a4d9b885749adbf061ecc73838579bda6c01262b964f6c34cd013aef