Racial discripancies in breast cancer in urban hospital retrospective analysis.
Authors: FN Rana, N Jasani
Journal: Cancer Research (2009)

Abstract Abstract #6098 Background: Certain races, specifically African-Americans, have less overall lifetime risk of developing breast cancer, but have higher mortality rates for the disease. Race has been found as an independent risk factor and may be associated with variables such as treatment differences, socio-economic factors and differences in biological behavior of tumor . The search for explanations for persistent disparity in outcomes of breast cancer between races particularly between African-American and Caucasian women stills seems to be elusive.The objective of this study was to help us better define if differences in outcomes for African-American women are due to specific tumor biology and/or socioeconomic issues. This will allow us to create programs with regards to screening, education and prevention directed toward high risk populations at our institution.&amp;#x2028; Methods and Participants: Subjects included 446 women ( 189 blacks and 257 non blacks) aged 27 to 91 residing in metropolitan Jacksonville, Fl who were diagnosed with invasive or noninvasive breast cancer. Information on stage, insurance status, tumor profile/subtype, demographics and menopausal status was obtained from analysis of tumor registry at University of Florida/Shands Hospital between 2000 and 2005. Aggressive subtype was defined as triple negative (ER-, PR-, Her2 -) or HER2 + only. Indigent insurance was defined as Medicaid or no insurance. Advanced stage disease was defined as Stage IIb or greater. Menopausal status was defined as age greater than 50 as post menopausal and equal to or less than 50 as pre-menopausal. Comparisons were made by race with breast cancer subtype, insurance status, menopausal status and advanced stage presentation with differences analyzed by Chi-Square test.&amp;#x2028; Results: There was a statistically significant difference in advanced stage disease between black and non-black patients (p= .0007). Advanced stage disease was present in 42% (95% confidence intervals [CI] 35% to 49%) of black females and in 28% (95% CI 22% to 33%) of non-blacks. There was a statistically significant difference in aggressive subtype between black and non-black females (p= .0012). Aggressive subtypes were present in 30% (95% CI 24% to 37%) of black females and 17% ( 95% CI 13% to 22%) in non-black females. Based on Cochrane Mantel-Haenszel analysis the odds of having an aggressive subtype are 1.81 (95% CI 1.13 to 2.89) times greater in pre-menopausal than post-menopausal females. An aggressive subtype was seen in 39% of black pre-menopausal females and in 27% of black post-menopausal females. There was no statistically significant difference in insurance status between black and non-black females.&amp;#x2028; Conclusion: Black females tend to have more advanced breast cancer at initial presentation and aggressive tumor subtypes than non-black females. Aggressive tumor subtypes occurred at a higher prevalance in pre-menopausal black females compared. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 6098.