This is a population based survival study of 145 African American (AA) and 177 white (W) women diagnosed with breast cancer in Connecticut between 1987 and 1989. As of January, 1999, 132 (41.0%)women had died (average time to death, 4.7 years). Survival among AAs (51.7%) was significantly lower than survival in Ws (65.0%) [age-adjusted Risk Ratio {RR} 1.82, p=.001]. The significant survival disadvantage persisted even with adjustment for age, TNM stage at diagnosis and one measure of socioeconomic status (education) [RR=1.62, p=.01). AA women were twice as likely to be diagnosed with tumors that were TNM stage II or higher (Odds Ratio [OR]=2.06, 95% Confidence Interval [CI] 1.29 - 3.30). Evaluating archived tissue specimens, we demonstrated race differences in a number of tumor characteristics and genetic alterations: AAs were more likely than Ws to have tumors that were higher histologic grade (p=.027), higher nuclear grade (p=.054), estrogen receptor negative (p=.019), and p53 positive (p=.001), all of which are associated with poorer prognosis. Although AA women were more likely than W women to be progesterone receptor negative (70% vs. 63%), and to express c-met (62% vs. 55%), differences were not statistically significant. AA women were not significantly more likely to be neu positive. Results suggest that p53, progesterone receptor status, histologic grade, and nuclear grade were predictive of poorer survival, particularly among AA women. C-met and neu were not significantly associated with survival in this population.
Learning Objectives: 1) Recognize that there are race differences in survival from breast cancer 2) Identify prognostic factors that explain the observed breast cancer survival difference between African American and white women
Keywords: Breast Cancer, Underserved Populations
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.