Abstract P6-10-06: Racial differences in the characteristics and outcomes of young breast cancer patients: A national population-based study
Authors: McClain JT , Mosquera C , Muzaffar M 
Published: February 2018

Background:

Disparity in demographic characteristics as it relates to breast cancer outcomes is well-studied. However, studies evaluating racial differences exclusively among young patients are more limited. We sought to examine socioeconomic and clinical factors and their impact on outcomes in young patients, as well as to determine whether variation in outcomes changed over the 22-year study period.

Methods:

Using the Surveillance, Epidemiology, and End Results (SEER) database, we identified female patients aged 20-35 with invasive breast cancer diagnosed from 1990-2012. We performed univariate, multivariate and survival analysis. Variables included patient age, race, stage, receptor status, surgery type and year of diagnosis

Results:

A total of 18,999 women were identified and analyzed. Mean age was 31.7 years. 31.2% were diagnosed between 1990-2000 while 68.7% were diagnosed between 2001-2012. 80.8% (15,364) of patients were white and 19.1% (3,635) were black. A higher percentage of blacks had stage III/IV disease (34% v 27%) and ≥ 4 positive nodes (19% v 16%) compared to whites. 54% of whites were ER receptor positive while 46% of blacks were ER receptor positive (p&lt;0.0001). White patents were more likely to live in counties where ≤15% of households were below the poverty line (64% v 45%) and where ≤15% of the population had less than a high school education (35% v 28%) compared to blacks.

The overall 5-year disease specific survival (DSS) for the entire cohort was 82.5%. 5-year DSS was 84.4% for all white patients and 74.2% for all black patients (p&lt;0.0001). 5-year DSS was 79.1% among all patients diagnosed from 1990-2000 and 84.2% among patients diagnosed from 2001-2012 (p&lt;0.0001). While the 5-year DSS for white patients improved from 80.9% in 1990-2000 to 86.3% in 2001-2012 (p&lt;0.0001), the 5-year DSS improvement for black patients from 1990-2000 to 2001-2012 did not reach statistical significance (71.3% vs 75.7 %, p=0.24).

Discussion:

Racial disparity among breast cancer patients is also an issue in young females, as young white patients have superior disease-specific survival compared to African-Americans collectively and in each time-period studied. Absolute disease-specific survival has improved from 1990-2000 to 2001-2012 for both races. However, the statistically significant difference in improvement of disease-specific survival seen among white patients was not demonstrated in African-American patients. Continued attention to racial disparity in breast cancer outcomes is needed with additional studies examining potential differences in treatment, disease characteristics and biology, and accessibility to health care, with a particular focus on young cancer patients. With continued research, hopefully new treatment approaches will be developed to reduce this disparity.

5-Year Disease Specific SurvivalTime Period5 year DSSp value WhiteBlack 1990-200080.9%71.3%0.00012001-201286.3%75.7%0.0001p value0.00010.24 

Survival by stage 5 yr DSS  WhiteBlackp valueStage I96.2%94.9%&lt;0.001Stage II89.0%83.5%&lt;0.0001Stage III69.4%57.4%&lt;0.0001Stage IV34.6%16.9%&lt;0.0001

Citation Format: McClain JT, Mosquera C, Muzaffar M. Racial differences in the characteristics and outcomes of young breast cancer patients: A national population-based study [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-10-06.