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Outcomes of Hormone-Receptor Positive, HER2-Negative Breast Cancers by Race and Tumor Biological Features.

Publication ,  Journal Article
Benefield, HC; Reeder-Hayes, KE; Nichols, HB; Calhoun, BC; Love, MI; Kirk, EL; Geradts, J; Hoadley, KA; Cole, SR; Earp, HS; Olshan, AF ...
Published in: JNCI Cancer Spectr
February 2021

BACKGROUND: Black women have higher hormone receptor positive (HR+) breast cancer mortality than White women. Early recurrence rates differ by race, but little is known about genomic predictors of early recurrence among HR+ women. METHODS: Using data from the Carolina Breast Cancer Study (phase III, 2008-2013), we estimated associations between race and recurrence among nonmetastatic HR+/HER2-negative tumors, overall and by PAM50 Risk of Recurrence score, PAM50 intrinsic subtype, and tumor grade using survival curves and Cox models standardized for age and stage. Relative frequency differences (RFD) were estimated using multivariable linear regression. To assess intervention opportunities, we evaluated treatment patterns by race among patients with high-risk disease. RESULTS: Black women had higher recurrence risk relative to White women (crude hazard ratio = 1.81, 95% confidence interval [CI] = 1.34 to 2.46), which remained elevated after standardizing for clinical covariates (hazard ratio = 1.42, 95% CI = 1.05 to 1.93). Racial disparities were most pronounced among those with high PAM50 Risk of Recurrence score (5-year standardized recurrence risk = 18.9%, 95% CI = 8.6% to 29.1% in Black women vs 12.5%, 95% CI = 2.0% to 23.0% in White women) and high grade (5-year standardized recurrence risk = 16.6%, 95% CI = 11.7% to 21.5% in Black women vs 12.0%, 95% CI = 7.3% to 16.7% in White women). However, Black women with high-grade tumors were statistically significantly less likely to initiate endocrine therapy (RFD = -8.3%, 95% CI = -15.9% to -0.6%) and experienced treatment delay more often than White women (RFD = +9.0%, 95% CI = 0.3% to 17.8%). CONCLUSIONS: Differences in recurrence by race appear greatest among women with aggressive tumors and may be influenced by treatment differences. Efforts to identify causes of variation in cancer treatment are critical to reducing outcome disparities.

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Published In

JNCI Cancer Spectr

DOI

EISSN

2515-5091

Publication Date

February 2021

Volume

5

Issue

1

Location

England

Related Subject Headings

  • Young Adult
  • White People
  • Tumor Burden
  • Time Factors
  • Receptors, Progesterone
  • Receptors, Estrogen
  • Receptor, erbB-2
  • Receptor, ErbB-2
  • RNA, Neoplasm
  • Proportional Hazards Models
 

Citation

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Benefield, H. C., Reeder-Hayes, K. E., Nichols, H. B., Calhoun, B. C., Love, M. I., Kirk, E. L., … Troester, M. A. (2021). Outcomes of Hormone-Receptor Positive, HER2-Negative Breast Cancers by Race and Tumor Biological Features. JNCI Cancer Spectr, 5(1). https://doi.org/10.1093/jncics/pkaa072
Benefield, Halei C., Katherine E. Reeder-Hayes, Hazel B. Nichols, Benjamin C. Calhoun, Michael I. Love, Erin L. Kirk, Joseph Geradts, et al. “Outcomes of Hormone-Receptor Positive, HER2-Negative Breast Cancers by Race and Tumor Biological Features.JNCI Cancer Spectr 5, no. 1 (February 2021). https://doi.org/10.1093/jncics/pkaa072.
Benefield HC, Reeder-Hayes KE, Nichols HB, Calhoun BC, Love MI, Kirk EL, et al. Outcomes of Hormone-Receptor Positive, HER2-Negative Breast Cancers by Race and Tumor Biological Features. JNCI Cancer Spectr. 2021 Feb;5(1).
Benefield, Halei C., et al. “Outcomes of Hormone-Receptor Positive, HER2-Negative Breast Cancers by Race and Tumor Biological Features.JNCI Cancer Spectr, vol. 5, no. 1, Feb. 2021. Pubmed, doi:10.1093/jncics/pkaa072.
Benefield HC, Reeder-Hayes KE, Nichols HB, Calhoun BC, Love MI, Kirk EL, Geradts J, Hoadley KA, Cole SR, Earp HS, Olshan AF, Carey LA, Perou CM, Troester MA. Outcomes of Hormone-Receptor Positive, HER2-Negative Breast Cancers by Race and Tumor Biological Features. JNCI Cancer Spectr. 2021 Feb;5(1).

Published In

JNCI Cancer Spectr

DOI

EISSN

2515-5091

Publication Date

February 2021

Volume

5

Issue

1

Location

England

Related Subject Headings

  • Young Adult
  • White People
  • Tumor Burden
  • Time Factors
  • Receptors, Progesterone
  • Receptors, Estrogen
  • Receptor, erbB-2
  • Receptor, ErbB-2
  • RNA, Neoplasm
  • Proportional Hazards Models