Abstract C27: Breast cancer presentation in a cohort of Afro-American women and Afro-Caribbean women diagnosed at University of Miami/Jackson Memorial Hospital
Authors: Marill Rochelle , Braithwaite Keren , Monge Jorge , Byrnes Diana , George Sophia , Hurley Judith 
Published: March 2017

Abstract
Background: It is documented that socioeconomic factors, such as lack of access to health care and inadequate treatment after diagnosis contribute to disparities in breast cancer, but these factors alone do not explain breast cancer disparities. Several studies suggest that several other factors, such as environmental, biological and behavioral factors may play a significant role in the observed disparities in breast cancer outcomes in women in minorities. In this study we compare Afro-Caribbean (AC) women born in the Caribbean and living in the United States and Afro-American (AA) women born and living in the United States, with a diagnosis of breast cancer in order to evaluate the effect of immigration and place of residency.
Methods: We conducted a retrospective chart review study of black women of AA and AC origin diagnosed with breast cancer at University of Miami/Jackson Memorial Hospital between 2005 and 2015 (n = 745). For each of the groups, we collected demographic data including age, body mass index (BMI), menopausal state, and TNM stage, receptor expression of estrogen and progesterone, Her-2/neu expression, gravidity and parity. Continuous data were analyzed using independent samples t-tests when parametric and using Wilcoxon-Mann-Whitney tests when non-parametric; categorical and binary data were analyzed using Chi-squared tests.
Results: We analyzed data from 745 black female patients: AA (n = 281) AC (n = 422). Place of birth was not available for 42 women. Mean age was 54.9 and 53.7 in AC and AA women, respectively. AA women had higher BMI (32.1 vs 29.8, p = 0.0001), lower proportion of HER2 positive breast cancer (12% vs 19%, p = 0.027) and more children (3.1 vs 2.8, p = 0.023) than AC. There was no difference in age (54.9 vs 53.7), premenopausal status (33% vs 31%), stage 3 or 4 (38% vs 37%), ER+ (63% vs 62%) or triple negative breast cancer (27% vs 31%) in AC compared with AA women (Table 1).
Conclusion: Jackson Memorial Hospital is a Safety-Net hospital for the 2.4 million residents of Miami-Dade County. The average age of our cohort was 54 years, ER 63% positive, Stage 3 was 27% and triple negative breast cancer was 29%. Compared to SEER data, our patients developed breast cancer one decade earlier, had a higher rate of triple negative breast cancer and higher stage at presentation. This was not affected by immigration status although the AC women were thinner and had fewer children.
Table 1.ACAAAAUSA(UM/JMH)(UM/JMH)(SEER)(SEER)Age55545863Age &lt;50y29%35%25.7%18.3%Stage 3 or 438%37%19.3%12.8%ER+63%62%73%84%Her-2+19%12%19.7%16.1%Triple Negative27%31%11.9%5.5%
Citation Format: Rochelle Marill, Keren Braithwaite, Jorge Monge, Diana Byrnes, Sophia George, Judith Hurley. Breast cancer presentation in a cohort of Afro-American women and Afro-Caribbean women diagnosed at University of Miami/Jackson Memorial Hospital. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr C27.