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Racial disparity in survival from estrogen and progesterone receptor-positive breast cancer: implications for reducing breast cancer mortality disparities

  • Epidemiology
  • Published:
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Abstract

Introduction

Non-Latina black breast cancer patients experience a shorter survival from breast cancer than their non-Latina white counterparts. We compared breast cancer-specific survival for the subset of black and white patients with estrogen and/or progesterone receptor-positive tumors that are generally targeted with endocrine therapy.

Methods

Using data collected from a population-based cohort of breast cancer patients from Chicago, IL, Kaplan–Meier survival curves and hazard functions were generated and proportional hazards models were estimated to determine the black/white disparity in time to death from breast cancer while adjusting for age at diagnosis, patient characteristics, treatment-related variables, and tumor grade and stage.

Results

In regression models, hazard of breast cancer death among ER/PR-positive patients was at least 4 times higher for black than for white patients in all models tested. Notably, even after adjusting for stage at diagnosis, tumor grade, and treatment variables (including initiation of systemic adjuvant therapies), the hazard ratio for death from ER/PR-positive breast cancer between black and white women was 4.39 (95% CI 1.76, 10.9, p = 0.001).

Conclusions

We observed a racial disparity in breast cancer survival for patients diagnosed with ER/PR-positive tumors that did not appear to be due to differences in tumor stage, grade, or therapy initiation in black patients, suggesting that there may be racial differences in the molecular characteristics of hormone receptor-positive tumors, such that ER/PR-positive tumors in black patients may be less responsive to standard treatments.

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Acknowledgements

We thank the Illinois women diagnosed with breast cancer whose information was reported to the Illinois State Cancer Registry thereby making this research possible. The conclusions, opinions, and recommendations expressed are not necessarily the conclusions, opinions, or recommendations of the Illinois State Cancer Registry.

Funding

This work was supported by two Grants from the National Cancer Institute at the National Institutes of Health to the University of Illinois at Chicago (Grants 1P50CA106743, 2P50CA106743).

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Authors and Affiliations

  1. Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, MC 923, Chicago, IL, 60612, USA

    Garth H. Rauscher

  2. Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA

    Garth H. Rauscher

  3. Department of Public Health Sciences, Loyola University, Chicago, IL, USA

    Abigail Silva

  4. Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Hines, IL, USA

    Abigail Silva

  5. College of Nursing, University of Illinois at Chicago, Chicago, IL, USA

    Heather Pauls

  6. Department of Physiology and Biophysics, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA

    Jonna Frasor

  7. Departments of Medicine and Pathology, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA

    Marcelo G. Bonini

  8. Division of Hematology/Oncology, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA

    Kent Hoskins

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  1. Garth H. Rauscher
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Correspondence to Garth H. Rauscher.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Rauscher, G.H., Silva, A., Pauls, H. et al. Racial disparity in survival from estrogen and progesterone receptor-positive breast cancer: implications for reducing breast cancer mortality disparities. Breast Cancer Res Treat 163, 321–330 (2017). https://doi.org/10.1007/s10549-017-4166-z

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  • DOI: https://doi.org/10.1007/s10549-017-4166-z

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