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Borderline Estrogen Receptor-Positive Breast Cancers in Black and White Women.

Publication ,  Journal Article
Benefield, HC; Allott, EH; Reeder-Hayes, KE; Perou, CM; Carey, LA; Geradts, J; Sun, X; Calhoun, BC; Troester, MA
Published in: J Natl Cancer Inst
July 1, 2020

BACKGROUND: Some breast tumors expressing greater than 1% and less than 10% estrogen receptor (ER) positivity (ER-borderline) are clinically aggressive; others exhibit luminal biology. Prior ER-borderline studies included few black participants. METHODS: Using the Carolina Breast Cancer Study (phase I: 1993-1996; 2: 1996-2001; 3: 2008-2013), a population-based study that oversampled black women, we compared ER-borderline (n = 217) to ER-positive (n = 1885) and ER-negative (n = 757) tumors. PAM50 subtype and risk of recurrence score (ROR-PT, incorporates subtype, proliferation, tumor size) were measured. Relative frequency differences (RFD) were estimated using multivariable linear regression. Disease-free interval (DFI) was evaluated by ER category and endocrine therapy receipt, overall and by race, using Kaplan Meier and Cox models. Statistical tests were two-sided. RESULTS: ER-borderlines were more frequently basal-like (RFD = +37.7%, 95% confidence interval [CI] = 27.1% to 48.4%) and high ROR-PT (RFD = +52.4%, 95% CI = 36.8% to 68.0%) relative to ER-positives. Having a high ROR-PT ER-borderline tumor was statistically significantly associated with black race (RFD = +26.2%, 95% CI = 9.0% to 43.3%). Compared to ER-positives, DFI of ER-borderlines treated with endocrine therapy was poorer but not statistically significantly different (hazard ratio [HR] = 2.03, 95% CI = 0.89% to 4.65%), whereas DFI was statistically significantly worse for ER-borderlines without endocrine therapy (HR = 3.33, 95% CI = 1.84% to 6.02%). However, black women with ER-borderline had worse DFI compared to ER-positives, even when treated with endocrine therapy (HR = 2.77, 95% CI = 1.09% to 7.04%). CONCLUSIONS: ER-borderline tumors were genomically heterogeneous, with survival outcomes that differed by endocrine therapy receipt and race. Black race predicted high-risk ER-borderlines and may be associated with poorer endocrine therapy response.

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Published In

J Natl Cancer Inst

DOI

EISSN

1460-2105

Publication Date

July 1, 2020

Volume

112

Issue

7

Start / End Page

728 / 736

Location

United States

Related Subject Headings

  • Young Adult
  • White People
  • Transcriptome
  • Receptors, Estrogen
  • Oncology & Carcinogenesis
  • North Carolina
  • Neoplasm Staging
  • Middle Aged
  • Immunohistochemistry
  • Humans
 

Citation

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Benefield, H. C., Allott, E. H., Reeder-Hayes, K. E., Perou, C. M., Carey, L. A., Geradts, J., … Troester, M. A. (2020). Borderline Estrogen Receptor-Positive Breast Cancers in Black and White Women. J Natl Cancer Inst, 112(7), 728–736. https://doi.org/10.1093/jnci/djz206
Benefield, Halei C., Emma H. Allott, Katherine E. Reeder-Hayes, Charles M. Perou, Lisa A. Carey, Joseph Geradts, Xuezheng Sun, Benjamin C. Calhoun, and Melissa A. Troester. “Borderline Estrogen Receptor-Positive Breast Cancers in Black and White Women.J Natl Cancer Inst 112, no. 7 (July 1, 2020): 728–36. https://doi.org/10.1093/jnci/djz206.
Benefield HC, Allott EH, Reeder-Hayes KE, Perou CM, Carey LA, Geradts J, et al. Borderline Estrogen Receptor-Positive Breast Cancers in Black and White Women. J Natl Cancer Inst. 2020 Jul 1;112(7):728–36.
Benefield, Halei C., et al. “Borderline Estrogen Receptor-Positive Breast Cancers in Black and White Women.J Natl Cancer Inst, vol. 112, no. 7, July 2020, pp. 728–36. Pubmed, doi:10.1093/jnci/djz206.
Benefield HC, Allott EH, Reeder-Hayes KE, Perou CM, Carey LA, Geradts J, Sun X, Calhoun BC, Troester MA. Borderline Estrogen Receptor-Positive Breast Cancers in Black and White Women. J Natl Cancer Inst. 2020 Jul 1;112(7):728–736.
Journal cover image

Published In

J Natl Cancer Inst

DOI

EISSN

1460-2105

Publication Date

July 1, 2020

Volume

112

Issue

7

Start / End Page

728 / 736

Location

United States

Related Subject Headings

  • Young Adult
  • White People
  • Transcriptome
  • Receptors, Estrogen
  • Oncology & Carcinogenesis
  • North Carolina
  • Neoplasm Staging
  • Middle Aged
  • Immunohistochemistry
  • Humans