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Racial disparity in survival from estrogen and progesterone receptor-positive breast cancer: implications for reducing breast cancer mortality disparities

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posted on 18.06.2018 by Garth H. Rauscher, Abigail Silva, Heather Pauls, Jonna Frasor, Marcelo G. Bonini, Kent Hoskins
Introduction Non-Latina black breast cancer patients experience a shorter survival from breast cancer than their non-Latina white counterparts. We compared breast cancer-specific survival for the subset of black and white patients with estrogen and/or progesterone receptor-positive tumors that are generally targeted with endocrine therapy. Methods Using data collected from a population-based cohort of breast cancer patients from Chicago, IL, Kaplan–Meier survival curves and hazard functions were generated and proportional hazards models were estimated to determine the black/white disparity in time to death from breast cancer while adjusting for age at diagnosis, patient characteristics, treatment-related variables, and tumor grade and stage. Results In regression models, hazard of breast cancer death among ER/PR-positive patients was at least 4 times higher for black than for white patients in all models tested. Notably, even after adjusting for stage at diagnosis, tumor grade, and treatment variables (including initiation of systemic adjuvant therapies), the hazard ratio for death from ER/PR-positive breast cancer between black and white women was 4.39 (95% CI 1.76, 10.9, p = 0.001). Conclusions We observed a racial disparity in breast cancer survival for patients diagnosed with ER/PR-positive tumors that did not appear to be due to differences in tumor stage, grade, or therapy initiation in black patients, suggesting that there may be racial differences in the molecular characteristics of hormone receptor-positive tumors, such that ER/PR-positive tumors in black patients may be less responsive to standard treatments.

Funding

This work was supported by two grants from the National Cancer Institute at the National Institutes of Health to the University of Illinois at Chicago (grants 1P50CA106743, 2P50CA106743).

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Post print version of article may differ from published version. The final publication is available at springerlink.com; DOI: 10.1007/s10549-017-4166-z

Citation

Rauscher, G. H., Silva, A., Pauls, H., Frasor, J., Bonini, M. G. and Hoskins, K. Racial disparity in survival from estrogen and progesterone receptor-positive breast cancer: implications for reducing breast cancer mortality disparities. Breast Cancer Research and Treatment. 2017. 163(2): 321-330. 10.1007/s10549-017-4166-z.

Publisher

Springer Verlag

Language

en_US

issn

0167-6806

Issue date

01/03/2017

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