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Racial/ethnic disparities in risk of breast cancer mortality by molecular subtype and stage at diagnosis

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

Previous research has found significant survival disparities between Black and White women among select stages and subtypes of breast cancer, however other racial/ethnic groups have been less well-studied. This study expands on previous research, examining differences in breast cancer-specific mortality across multiple racial and ethnic groups.

Methods

Women diagnosed with a first primary invasive breast cancer between 2010 and 2016 who were 20–85 years of age at diagnosis were identified from 18 Surveillance, Epidemiology, and End Results (SEER) registries. Subtypes were defined by joint hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status. Cox proportional hazards models for each stage and subtype were fit, with non-Hispanic white women as the reference group. Effect modification by age at diagnosis (< 50, ≥ 50) was found and thus analyses were age-stratified.

Results

After multivariable adjustment, younger Black women had greater risks of breast cancer-specific death for all stages of HR+/HER2−, and certain stages of HR+/HER2+ , TN, and HR−/HER2 + breast cancer. Asian/Pacific Islander women generally had a lower hazard of breast cancer-specific death. Older Hispanic White women had a lower hazard of breast cancer-specific death for stages I-III HR + /HER2− and stage II TN breast cancer.

Conclusions

These findings demonstrate that different racial/ethnic groups experience different risks of breast cancer-specific mortality by stage and subtype. Efforts to address survival disparities should place additional focus on young Black women, as they experience meaningful disparities in breast cancer-specific mortality.

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Data availability

The datasets generated during and analyzed during the current study are publicly available from the surveillance, epidemiology, and end results (SEER) program upon request, https://seer.cancer.gov/.

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Funding

3R01CA189184-04S1 (Christopher I. Li) Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number R01CA189184. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. University of Washington, Seattle, WA, USA

    Nicole C. Lorona, Kathleen E. Malone & Christopher I. Li

  2. Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., M4-C308, Seattle, WA, 98109, USA

    Nicole C. Lorona, Kathleen E. Malone & Christopher I. Li

Authors
  1. Nicole C. Lorona
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  2. Kathleen E. Malone
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  3. Christopher I. Li
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by NCL. The first draft of the manuscript was written by Nicole Lorona and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Nicole C. Lorona.

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The authors declare no potential conflicts of interest.

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This article does not contain any studies with human participants performed by any of the authors.

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Lorona, N.C., Malone, K.E. & Li, C.I. Racial/ethnic disparities in risk of breast cancer mortality by molecular subtype and stage at diagnosis. Breast Cancer Res Treat 190, 549–558 (2021). https://doi.org/10.1007/s10549-021-06311-7

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  • DOI: https://doi.org/10.1007/s10549-021-06311-7

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