Abstract P5-10-06: Race associated disparities in an urban population of adolescent and young adult (AYA) women with breast cancer
Authors: Chitalia AA , Aqbal D , Yin R , Cai L , Isaacs CJ , Lynce FC 
Published: May 2019

Introduction: Although only about 5-7% of breast cancers occur in women under 40 years of age, multiple studies have shown that these cancers are more aggressive. In addition issues related to genetic testing and fertility preservation are of particular importance for AYA patients with breast cancer. This retrospective analysis aims to describe various biologic and treatment related factors of an urban AYA population with breast cancer and the differences amongst these factors stratified by African American (AA) versus non-AA race. We will look at factors including stage at diagnosis, hormone receptor status, prevalence of BRCA1/2 mutations, time from diagnosis to treatment, enrollment in clinical trials, and fertility preservation.

Methods: A retrospective study of a population of AYA women with breast cancer seen at two hospitals in Washington D.C. from 2006 to 2015 was performed. Data was collected on age, BRCA1/2 test results, stage at diagnosis, hormone receptor status, time from diagnosis to treatment, enrollment in clinical trial, fertility preservation, and pregnant or breastfeeding status at time of diagnosis. Fisher exact test was used to test the association between two categorical variables. Wilcoxon rank sum test was used to compare time to treatment and stage at presentation between AA and non-AA patients.

Results: A total of 161 AYA patients were evaluated. 54 were identified as AA and 107 as non-AA (88 Caucasians, 13 Asian, 6 Hispanics). Median age was 32 years (20-39) overall; 32 years (23-39) for AA and 33 years (20-39) for non-AA. While the rate of genetic testing was high, significantly fewer AA AYA underwent testing compared to non-AA (74% versus 87% respectively, (p=0.050)) and 10% of AA versus 22% of non-AA were found to have a BRCA1/2 deleterious mutation (p=NS). Clinical trial participation was lower for AA compared to non-AA (57% vs. 76%, p=NS) for those where clinical trials were discussed/offered. Fertility preservation was pursued by 10% of AA vs. 35% of non-AA (p=0.001). Of note, 61% of AA and 34% of non-AA had children at the time of diagnosis (p=0.001). While AA (31%) presented more often with advanced stages of cancer compared to non-AA (19%) this was not statistically significant. Triple negativity was similar in AA AYA (25%) vs. non-AA (22%). The median time to treatment initiation did not vary between AA and non-AA (37 days vs. 36 days, p=NS).

Conclusion: In this retrospective study of an urban population of AYA women with breast cancer, there were no delays in treatment initiation or significant differences between AA and non-AA. When compared to non-AA, AA had a statistically significant lower rate of genetic testing and fertility preservation, although the latest could have been affected by a higher number of nulliparous in non-AA. . Encouragingly, the clinical trial participation of AYA who had previously discussed clinical trials with their physician was very high.

Citation Format: Chitalia AA, Aqbal D, Yin R, Cai L, Isaacs CJ, Lynce FC. Race associated disparities in an urban population of adolescent and young adult (AYA) women with breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-10-06.