Abstract P6-10-04: “Disparities in breast cancer: A multi-institutional comparative analysis focusing on American Hispanics”
Authors: Otoukesh S , Nahleh Z , Mirshahidi HR , Nguyen AL , Botrus G , Badri N , Diab N , Alvarado A , Sanchez LA , Dwivedi A 
Published: February 2018

Background: Breast cancer (BC) is the leading cause of cancer death in Hispanic/Latina women nationwide. Hispanic women are more likely to be presented with advanced disease and might have adverse prognosis. Further, the Hispanics of Mexican-American origin might reflect different clinico-pathological characteristics as opposed to other Hispanics and ethnic groups. No previous largest studies comprised with Hispanics of Mexican-American origin explored tumor characteristics and compared to other ethnic groups. Thus, the aim of this study was to describe the clinico- pathological characteristics and disparities in breast cancer in this minority group at two tertiary care University- based medical centers in 2 states with a large Hispanic presence.

Methods: After IRB approval, cancer registry was used to analyze the variables of 3,441 patients with breast cancer diagnosed and treated consecutively at two large tertiary University based medical centers in El Paso, TX and Loma Linda, CA between 2005-2015. Unadjusted and adjusted associations of race/ethnicity with cancer stage, hormone receptor status and treatment option were investigated, as well as comparison to other ethnic groups.

Results: Overall 45.5% of the patients were Hispanic (n= 1566). Hispanics were more likely to be diagnosed at a younger age (57 years) compared to in non-Hispanic (NH) whites, more likely to have invasive ductal carcinoma type (82.7%) & triple negative disease (17.1%, 95%CI: 15% to 19%). 58.8% of Hispanics (95%CI: 56% to 61%) have HR+ & HER2- as opposed to 71% in NH whites. In addition, Hispanic individuals presented with advanced stages (III and IV) of BC (25.3%, 95% CI: 23% to 28%) similar to African Americans (25.4%), and had a lower proportion of lumpectomy versus mastectomy compared to NH whites (50%) but similar to African Americans (50%). Hispanic patients had the highest prevalence of triple negative BC (17.1% in Hispanics Versus 13.9 % in African Americans, versus 8.5% in NH whites). Hispanics also had significantly higher relative risk of HER2+/HR - disease (RRR=1.77, p&lt;0.0001) compared to NH whites with no difference in African Americans (RRR= 1.21, p=0.56).

Conclusions: This large multi-institutional study shows that Hispanics are diagnosed with breast cancer at a younger age, have a higher prevalence of triple negative and HER2 positive/HR- breast cancer, are diagnosed at more advanced stages of disease and undergo less lumpectomies compared to NH whites. Increased efforts geared toward early detection, improving awareness and access to health care is desperately needed in this rapidly increasing minority in the U.S.

Citation Format: Otoukesh S, Nahleh Z, Mirshahidi HR, Nguyen AL, Botrus G, Badri N, Diab N, Alvarado A, Sanchez LA, Dwivedi A. “Disparities in breast cancer: A multi-institutional comparative analysis focusing on American Hispanics” [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 P6-10-04.