Racial disparity in estrogen receptor positive breast cancer patients receiving trimodality therapy

J. L. Wright, I. M. Reis, W. Zhao, J. E. Panoff, C. Takita, V. Sujoy, C. R. Gomez, M. Jorda, D. Franceschi, J. Hurley

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Introduction: We assessed racial differences in progression-free survival (PFS) and overall survival (OS) in relation to subtype in uniformly treated stage II-III breast cancer patients. Methods: We reviewed records of 582 patients receiving post-mastectomy radiation (PMRT) between 1/1999 and 12/2009 and evaluated the effect of demographic, tumor, and treatment characteristics on PFS and OS. Results: Median follow up was 44.7 months. 24% of patients were black and 76% white. All had mastectomy and PMRT; 98% had chemotherapy; Estrogen receptor (ER)+ patients received endocrine therapy. Black patients were more likely to have ER- (56% vs. 38%, p = 0.0001), progesterone receptor (PR)- (69% vs. 54%, p = 0.002), and triple negative (TN) (46% vs. 24%, p < 0.0001) tumors. Overall, black patients had worse PFS (60.6% vs. 78.3%, p = 0.001) and OS (72.8% vs. 87.7%, p < 0.0001). There was no racial difference in PFS (p = 0.229 and 0.273 respectively) or OS (p = 0.113 and 0.097 respectively) among ER- or TN. Among ER+, black patients had worse PFS (55% vs. 81%, p < 0.001) and OS (73% vs. 91%, p < 0.0001). The difference in PFS was seen in the ER+/PR+/HER2- subgroup (p = 0.002) but not ER+/PR-/HER2- (p = 0.129), and in the post-menopausal ER+/HER2- subgroup (p = 0.004) but not pre/peri-menopausal ER+/HER2- (p = 0.150). Conclusions: Black women had worse survival outcomes in this cohort. This disparity was driven by (1) a higher proportion of ER- and TN tumors in black women and (2) worse outcome of similarly treated black women with ER+ breast cancer. The underlying causes of racial disparity within hormone receptor categories must be further examined.

Original languageEnglish (US)
Pages (from-to)276-283
Number of pages8
JournalBreast
Volume21
Issue number3
DOIs
StatePublished - Jun 2012

    Fingerprint

Keywords

  • Breast cancer
  • Estrogen receptor
  • Racial disparity
  • Trimodality therapy
  • Triple negative

ASJC Scopus subject areas

  • Surgery

Cite this