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Does race affect outcomes in triple negative breast cancer?

Sachdev JC, Ahmed S, Mirza MM, Farooq A, Kronish L, Jahanzeb M - Breast Cancer (Auckl) (2010)

Bottom Line: AA women >/=50 years at diagnosis had a significantly worse BCSS than the CA women in that age group (P = 0.012).Overall, there is a trend towards lower survival for AA women compared to Caucasians despite uniformity of tumor phenotype and treatment.The high early event rate, irrespective of race, underscores the need for effective therapies for women with TNBC.

View Article: PubMed Central - PubMed

Affiliation: University of Tennessee Health Science Center Memphis, TN.

ABSTRACT

Background: There is discordance among studies assessing the impact of race on outcome of patients with Triple Negative Breast Cancer (TNBC). We assessed survival outcomes for African American (AA) versus Caucasian (CA) women with TNBC treated at an urban cancer center in Memphis, TN with a predominant AA patient population.

Methods: Patients with Stage I-III TNBC were identified from our breast database. Event free survival (EFS) and Breast cancer specific survival (BCSS) were the primary outcome measures. Cox proportional hazards models were fitted for EFS and BCSS.

Results: Of the 124 patients, 71% were AA. No significant association between race and stage (P = 0.21) or menopausal status (P = 0.15) was observed. Median age at diagnosis was significantly lower for AA versus CA women (49.5 vs. 55 years, P = 0.024). 92% of the patients received standard neo/adjuvant chemotherapy, with no significant difference in duration and type of chemotherapy between the races. With a median follow up of 23 months, 28% of AA vs. 19% of CA women had an event (P = 0.37). 3 year EFS and BCSS trended favorably towards CA race (77% vs. 64%, log rank P = 0.20 and 92% vs. 76%, P = 0.13 respectively) with a similar trend noted on multiple variable modeling (EFS: HR 0.62, P = 0.29; BCSS: HR 0.36, P = 0.18). AA women >/=50 years at diagnosis had a significantly worse BCSS than the CA women in that age group (P = 0.012).

Conclusion: Older AA women with TNBC have a significantly worse breast cancer specific survival than their CA counterparts. Overall, there is a trend towards lower survival for AA women compared to Caucasians despite uniformity of tumor phenotype and treatment. The high early event rate, irrespective of race, underscores the need for effective therapies for women with TNBC.

No MeSH data available.


Related in: MedlinePlus

BCSS by race, P = 0.13.
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f1b-bcbcr-2010-023: BCSS by race, P = 0.13.

Mentions: With a median follow up of 23 months (range 1–124 months), 32 patients (26%) have had a breast cancer event, i.e. recurrence or death related to breast cancer (Table 2). The site of first relapse i.e. locoregional (LR) versus systemic ±locoregional (LRS) did not differ by race. The overall 3 year EFS and BCSS estimates for the cohort were 68% (SE, 5%) and 81% (SE, 5%) respectively. The three-year EFS and BCSS estimates for AA race were 64% and 76% respectively. The corresponding 3- year EFS and BCSS estimates for Caucasians were 77% and 92% respectively (Table 3). Figures 1a and 1b illustrate the Kaplan-Meier survival curves with the corresponding log-rank P-values for EFS and BCSS. Though the difference in survival between the two races did not reach statistical significance, both the unadjusted and stage adjusted survival (Figs. 2a and 2b) trend towards a better outcome for the Caucasian patients. When analyzed by age at diagnosis (<50 vs. ≥50), among the patients in the older age group, BCSS was significantly lower for AA patients compared to the CA patients (Fig. 3b; log-rank P-value = 0.012). There was no statistically significant survival difference noted between the races among the younger patients (Fig. 3a).


Does race affect outcomes in triple negative breast cancer?

Sachdev JC, Ahmed S, Mirza MM, Farooq A, Kronish L, Jahanzeb M - Breast Cancer (Auckl) (2010)

BCSS by race, P = 0.13.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2914275&req=5

f1b-bcbcr-2010-023: BCSS by race, P = 0.13.
Mentions: With a median follow up of 23 months (range 1–124 months), 32 patients (26%) have had a breast cancer event, i.e. recurrence or death related to breast cancer (Table 2). The site of first relapse i.e. locoregional (LR) versus systemic ±locoregional (LRS) did not differ by race. The overall 3 year EFS and BCSS estimates for the cohort were 68% (SE, 5%) and 81% (SE, 5%) respectively. The three-year EFS and BCSS estimates for AA race were 64% and 76% respectively. The corresponding 3- year EFS and BCSS estimates for Caucasians were 77% and 92% respectively (Table 3). Figures 1a and 1b illustrate the Kaplan-Meier survival curves with the corresponding log-rank P-values for EFS and BCSS. Though the difference in survival between the two races did not reach statistical significance, both the unadjusted and stage adjusted survival (Figs. 2a and 2b) trend towards a better outcome for the Caucasian patients. When analyzed by age at diagnosis (<50 vs. ≥50), among the patients in the older age group, BCSS was significantly lower for AA patients compared to the CA patients (Fig. 3b; log-rank P-value = 0.012). There was no statistically significant survival difference noted between the races among the younger patients (Fig. 3a).

Bottom Line: AA women >/=50 years at diagnosis had a significantly worse BCSS than the CA women in that age group (P = 0.012).Overall, there is a trend towards lower survival for AA women compared to Caucasians despite uniformity of tumor phenotype and treatment.The high early event rate, irrespective of race, underscores the need for effective therapies for women with TNBC.

View Article: PubMed Central - PubMed

Affiliation: University of Tennessee Health Science Center Memphis, TN.

ABSTRACT

Background: There is discordance among studies assessing the impact of race on outcome of patients with Triple Negative Breast Cancer (TNBC). We assessed survival outcomes for African American (AA) versus Caucasian (CA) women with TNBC treated at an urban cancer center in Memphis, TN with a predominant AA patient population.

Methods: Patients with Stage I-III TNBC were identified from our breast database. Event free survival (EFS) and Breast cancer specific survival (BCSS) were the primary outcome measures. Cox proportional hazards models were fitted for EFS and BCSS.

Results: Of the 124 patients, 71% were AA. No significant association between race and stage (P = 0.21) or menopausal status (P = 0.15) was observed. Median age at diagnosis was significantly lower for AA versus CA women (49.5 vs. 55 years, P = 0.024). 92% of the patients received standard neo/adjuvant chemotherapy, with no significant difference in duration and type of chemotherapy between the races. With a median follow up of 23 months, 28% of AA vs. 19% of CA women had an event (P = 0.37). 3 year EFS and BCSS trended favorably towards CA race (77% vs. 64%, log rank P = 0.20 and 92% vs. 76%, P = 0.13 respectively) with a similar trend noted on multiple variable modeling (EFS: HR 0.62, P = 0.29; BCSS: HR 0.36, P = 0.18). AA women >/=50 years at diagnosis had a significantly worse BCSS than the CA women in that age group (P = 0.012).

Conclusion: Older AA women with TNBC have a significantly worse breast cancer specific survival than their CA counterparts. Overall, there is a trend towards lower survival for AA women compared to Caucasians despite uniformity of tumor phenotype and treatment. The high early event rate, irrespective of race, underscores the need for effective therapies for women with TNBC.

No MeSH data available.


Related in: MedlinePlus