Disease-free, Overall Survival Inferior for Black Women with HR-positive Breast Cancer
December 11, 2009
• Results are not explained by lack of access to care or more advanced stage.
• Chemotherapy, hormonal therapy adherence was similar among groups.
SAN ANTONIO - Black women with hormone receptor (HR)-positive breast cancer had worse disease-free and overall survival, according to data presented at the CTRC-AACR San Antonio Breast Cancer Symposium, held Dec. 9-13, 2009.
"Black women had a higher risk for disease recurrence and inferior survival compared with women of other races," said Joseph A. Sparano, M.D., professor of medicine and women's health at Albert Einstein Medical College of Medicine and associate chairman of the Department of Oncology at Montefiore Medical Center in Bronx, N.Y.
"The worse outcome was seen only in those with HR-positive, HER-2-negative breast cancer, which is the most common type of breast cancer" he added.
Previous research has shown that black women have worse outcomes in operable breast cancer, likely explained by their higher incidence of more advanced-stage disease, more aggressive triple-negative disease, disparities in medical care, and comorbidities.
"When we controlled for these other factors to the extent possible, black race was still associated with a worse outcome, but only in HR-positive disease - this was a new and surprising finding," said Sparano.
The researchers evaluated survival outcomes in 4,817 women (405 were black) with stage 1 to 3 axillary lymph node-positive or high-risk node-negative breast cancer who had undergone surgery. The women were part of the Eastern Cooperative Oncology Group and Breast Cancer Intergroup trial E1199; they received doxorubicin and taxane-containing chemotherapy plus standard hormonal therapy.
"We found that black patients exhibited similar adherence to the chemotherapy and hormonal therapy, and they didn't do worse if they had other breast cancer subtypes. This indicates that black women with HR-positive breast cancer are more prone to have disease recurrence despite state-of-the-art medical care," said Sparano.
The researchers are planning additional studies to evaluate whether these findings can be attributed to differences in black women's ability to metabolize hormonal therapies.
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The mission of the CTRC-AACR San Antonio Breast Cancer Symposium is to produce a unique and comprehensive scientific meeting that encompasses the full spectrum of breast cancer research, facilitating the rapid translation of new knowledge into better care for breast cancer patients. The Cancer Therapy & Research Center (CTRC) at The University of Texas Health Science Center at San Antonio, the American Association for Cancer Research (AACR), and Baylor College of Medicine are joint sponsors of the San Antonio Breast Cancer Symposium. This collaboration utilizes the clinical strengths of the CTRC and Baylor, and the AACR's scientific prestige in basic, translational and clinical cancer research to expedite the delivery of the latest scientific advances to the clinic. The 32nd annual symposium is expected to draw more than 8,500 participants from more than 90 countries.
In San Antonio Dec. 9-13: