Outcome of African American (AA) compared to white American (WA) patients with early-stage breast cancer, stratified by phenotype

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Conference Proceeding

Publication Date


Publication Title

Ann Surg Oncol


INTRODUCTION: Population-based breast cancer mortality rates are approximately 40% higher for AA compared to WA women. The extent to which these outcome disparities are related to the two-fold higher incidence of triple negative breast cancer (TNBC) in AAs is unclear. Methods: We evaluated survival among AA and WA pts presenting with clinically early-stage/node negative breast cancer, stratified by having TNBC versus non-TNBC phenotype from a prospectively-maintained, IRB-approved database in an employee health plan-based hospital system serving a diverse community; Median follow-up was 60 months. Results: A total of 2,847 cases were analyzed; 1,061 (37%) AA and 1,786 (63%) WA. Frequency of TNBC was higher among the AA patients compared to WA patients (15% versus 10%; p<0.05) and frequency of non-TNBC/HER2-negative disease was lower among AA compared to WA patients (53% versus 62%; p<0.05). Median survival of AA compared to WA pts was shorter (median survival 1175 versus 1691 days; Wilcoxon p-value 0.002), but median survival of AA and WA TNBC pts was not statistically different (1094 versus 1636 days; p-value 0.397). Outcome disparities re-emerged for AA compared to WA pts with HER2-positive/non-TNBC (median survival 1210 versus 1717 days; p-value 0.015), and for HER2-negative/non-TNBC (median survival 1722 versus 2088 days; p-value 0.10) although the difference was not statistically significant for the latter. Conclusions: Variation in TNBC prevalence likely contributes to race-associated breast cancer disparities overall, but outcome differences associated with HER2-positive and hormone receptor-positive disease suggest that variations in delivery of targeted therapy or response to targeted therapy may also be playing a role.




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