Abstract A02: Breast cancer recurrence patterns among ethnically distinct populations: A single institution large cohort study
Authors: Wright Nikita , Neema Pranay , Osan Remus , Xia Jun , Wells Stephen , Venable Josef G. , Jones Mildred , Rida Padmashree , Aneja Ritu , Cantuaria Guilherme 
Published: May 2016

African-American (AA) women with breast cancer have worse overall survival compared with European-American (EA) women with breast cancer for reasons that are incompletely understood. A primary risk factor for breast cancer-specific mortality is disease recurrence, yet racial distinctions in recurrence patterns remain poorly characterized. Evaluation of the risk of recurrence upon initial diagnosis is crucial for clinicians to customize an optimal treatment plan. Prognostic factors associated with recurrence include lymph node involvement, larger tumor size, earlier age at diagnosis, and triple-negative receptor status. These poor prognostic indicators have been associated with AA race. In this study, we examined rates and patterns of recurrence in a large cohort of breast cancer patients (n=10504) treated from 2005-2015 at Northside Hospital in Atlanta, GA. We observed that AA breast cancer patients (n=1850) exhibited a higher frequency of recurrences than EA breast cancer patients (n=7931) (p=0.047). Moreover, AA breast cancer patients exhibited a trend towards regional and distant recurrences, which are more fatal, whereas EA breast cancer patients displayed a higher inclination towards local recurrences that show a better prognosis. However, while these trends were robust, they did not achieve significance perhaps owing to the small number of patients in recurrence location subcategories. Importantly, overall survival was worse among AA patients with distant recurrences (n=26) than EA breast cancer patients with distant recurrences (n=80) (p=0.01). Furthermore, among patients who underwent lymph node surgery, regional recurrence was more likely among AAs (n=1030) than EAs (n=5252) (p=0.045). Among patients who received radiation, there was a non-significant trend towards AAs (n=874) exhibiting a greater propensity toward disease recurrence than EAs (n=3734). This study illuminates striking differences in recurrence patterns among AA and EA breast cancer patients by exposing that AA patients are more likely to experience more aggressive non-local recurrences, and are at a greater risk of mortality from distant recurrences. Collectively, these findings help to explain the accelerated progression of the disease and lower survival rates in AA breast cancer patients compared with their EA counterparts, underscoring the urgent need for clinicians to consider race in screening programs and when devising treatment plans.

Citation Format: Nikita Wright, Pranay Neema, Remus Osan, Jun Xia, Stephen Wells, Josef G. Venable, Mildred Jones, Padmashree Rida, Ritu Aneja, Guilherme Cantuaria. Breast cancer recurrence patterns among ethnically distinct populations: A single institution large cohort study. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr A02.