Racial and ethnic disparities in 21-gene recurrence scores, chemotherapy, and survival among women with hormone receptor
- PDF / 499,035 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 22 Downloads / 146 Views
EPIDEMIOLOGY
Racial and ethnic disparities in 21‑gene recurrence scores, chemotherapy, and survival among women with hormone receptor‑positive, node‑negative breast cancer Yunan Han1,2 · Zhi‑Feng Miao3,4 · Min Lian5,6 · Lindsay L. Peterson7 · Graham A. Colditz1,6 · Ying Liu1,6 Received: 25 October 2019 / Accepted: 29 August 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose Cutoffs of the 21-gene recurrence score (RS), a commonly used genomic assay for hormone receptor-positive breast cancer, have been updated. Little is known about racial/ethnic differences in RS results, RS-guided chemotherapy use, and outcomes on updated cutoff (RS ≥ 31 defined as high-risk) in the real-world setting. Methods A total of 81,937 women [75.0% whites, 7.7% blacks, 8.3% Asian American/Pacific Islanders (AAPIs), and 9.0% Hispanics] diagnosed with hormone receptor-positive breast cancer between 2004 and 2015, who received the 21-gene assay, were identified from the Surveillance, Epidemiology, and End Results. Logistic regressions estimated the race-associated odds ratios (ORs) of RS and chemotherapy use. Cox regressions estimated the race-associated hazard ratios (HRs) of breast cancer-specific and all-cause mortality. Results Compared with white women, black women were more likely to have RS-defined high-risk tumors (adjusted OR [aOR] 1.29; 95% CI 1.16–1.42). In high RS, blacks had lower odds of chemotherapy use (aOR 0.76; 95% CI 0.62–0.94) than whites, particularly among women ≥ 65 years (aOR 0.51; 95% CI 0.35–0.76), while AAPI and Hispanic women had no variation in chemotherapy use compared with whites in high RS. Black women had a higher risk of breast cancer-specific mortality (HR 1.37; 95% CI 1.12–1.67) and all-cause mortality compared with white women after adjusting for demographic and pathological factors, county-level socioeconomic deprivation, treatments and RS; AAPIs had lower mortality and Hispanics had similar mortality. Conclusions Black women were more likely to have a high-risk RS tumor and less likely to receive chemotherapy in the group of high RS, especially those ≥ 65 years. Further studies are needed to identify barriers to chemotherapy in black patients with high RS scores. Keywords Breast cancer · Race · 21-gene · Recurrence score · Oncotype DX · Chemotherapy · Survival Abbreviations AAPI Asian Americans/Pacific Islander CI Confidence interval HER2 Human epidermal growth factor receptor 2 HR Hazard ratio NCCN National Comprehensive Cancer Network OR Odds ratio RS Recurrence score Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10549-020-05902-0) contains supplementary material, which is available to authorized users. * Ying Liu [email protected] Extended author information available on the last page of the article
RUCC Rural–urban continuum codes SEER Surveillance, epidemiology, and end results TAILORx Trial assigning individualized options for treatment
Introduction Breast cancer is the most commonly di
Data Loading...
