High prevalence of triple‐negative tumors in an urban cancer center

• Published in: Cancer Vol. 113; no. 3; pp. 608 - 615
• Main Authors: Lund, Mary Jo B., Butler, Ebonee N., Bumpers, Harvey L., Okoli, Joel, Rizzo, Monica, Hatchett, Nadjo, Green, Victoria L., Brawley, Otis W., Oprea‐Ilies, Gabriela M., Gabram, Sheryl G. A.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.08.2008; Wiley-Liss
• Subjects: Adult; African Americans - statistics & numerical data; African‐American; Aged; Aged, 80 and over; Biological and medical sciences; breast cancer; Breast Neoplasms - epidemiology; Breast Neoplasms - metabolism; Breast Neoplasms - pathology; Female; Gynecology. Andrology. Obstetrics; Hospitals, Urban; Humans; Mammary gland diseases; Medical Oncology; Medical sciences; Middle Aged; mortality; Neoplasm Invasiveness; Prevalence; race/ethnicity; Receptor, ErbB-2 - metabolism; Receptors, Estrogen - metabolism; Receptors, Progesterone - metabolism; Social Class; subtypes; triple negative; Tumors; Breast disease; Urban environment; Prevalence; Mortality; Breast cancer; Malignant tumor; Epidemiology; Ethnic group; race/ethnicity; subtypes; Mammary gland diseases; Cancerology; African-American; Race; triple negative; Subtype; Cancer; African American
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.23569

BACKGROUND. A disparate proportion of breast cancer deaths occur among young women, those of African‐American (AA) ancestry, and particularly young AA women. Estrogen receptors (ER), progesterone receptors (PR), and human epidermal growth factor receptor‐2 (HER‐2) are key clinically informative biomarkers. The triple‐negative (ER‐/PR‐/HER‐2‐) tumor subgroup is intrinsically resistant to treatment and portends a poor prognosis. Age, race, and socioeconomic status have been associated with triple‐negative tumors (TNT). In the current study, the authors investigated breast cancer subgroups among patients in an urban cancer center serving a multiracial, low socioeconomic population. METHODS. This case series analyzed female invasive breast cancers diagnosed and/or treated between 2003 and 2004 in the AVON Comprehensive Breast Center at Grady Hospital in Atlanta, Georgia. Data were obtained from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program, and augmented by the hospital registry and pathology reports. Statistical analyses utilized frequency distributions and logistic regression. RESULTS. Of 190 breast cancers; 167 (88%) were diagnosed among AA and 23 (12%) were diagnosed among non‐AA women. The median age at diagnosis in the 2 groups was 58 years and 57 years, respectively. TNT prevalence was found to differ by race (29.3% among AA women and 13.0% among non‐AA women; P = .010). Differences persisted after adjustment for age and stage (odds ratio [OR] of 3.1; 95%confidence interval [95% CI], 0.8–11.6). The majority of recurrences (40.0%) occurred among women with TNT, who were also most likely to experience a fatal event (OR of 3.7; 95%CI, 1.1–13.0). CONCLUSIONS. Despite a similarity in their age at diagnosis, AA women in our urban cancer center presented with a higher prevalence of TNT and TNT was found to predict the poorest outcomes. Institutional interactive breast conferences and intervention/navigation programs could help to dispel breast cancer disparities and improve outcomes. Cancer 2008. © 2008 American Cancer Society. A disparate proportion of breast cancer deaths occur among young women and those of African‐American ancestry. In the authors' cancer center, which provides care to a multiracial, underserved population, despite similarity in age at diagnosis, African‐American women presented with a significantly higher prevalence of triple‐negative tumors, which was found to be predictive of the poorest recurrence and mortality outcomes.