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Association of race/ethnicity, socioeconomic status, and breast cancer subtypes in the National Cancer Data Base (2010–2011)

  • Epidemiology
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Abstract

To estimate the odds of breast cancer subtypes in minority populations versus non-Hispanic (NH) whites stratified by socioeconomic status (SES) [a composite of individual-level SES (insurance status) and area-level SES (median household income quartile from 2000 U.S. Census data)] using a large nationwide cancer database. We used the National Cancer Data Base to identify breast cancer cases diagnosed in 2010 and 2011, the only 2 years since U.S. cancer registries uniformly began collecting HER2 results. Breast cancer cases were classified into five subtypes based on hormone receptor (HR) and HER2 status: HR+/HER2−, HR+/HER2+, HR−/HER2+ (HER2-overexpressing), HR−/HER2− (TN), and unknown. A polytomous logistic regression was used to estimate odds ratios (ORs) comparing the odds of non-HR+/HER2-subtypes to HR+/HER2− for racial/ethnic groups controlling for and stratifying by SES, using a composite of insurance status and area-level income. Compared with NH whites, NH blacks and Hispanics were 84 % (OR = 1.84; 95 % CI 1.77–1.92) and 17 % (OR = 1.17; 95 % CI 1.11–1.24) more likely to have TN subtype versus HR+/HER2−, respectively. Asian/Pacific Islanders (API) had 1.45 times greater odds of being diagnosed with HER2-overexpressing subtype versus HR+/HER2− compared with NH whites (OR = 1.45; 95 % CI 1.31–1.61). We found similar ORs for race in high and low strata of SES. In a large nationwide hospital-based dataset, we found higher odds of having TN breast cancer in black women and of HER2-overexpressing in API compared with white women in every level of SES.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. American Cancer Society, Inc.,, 250 Williams Street NW, Atlanta, GA, 30303, USA

    Helmneh M. Sineshaw, Mia Gaudet, Elizabeth M. Ward, W. Dana Flanders, Carol Desantis, Chun Chieh Lin & Ahmedin Jemal

  2. Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA, 30322, USA

    W. Dana Flanders

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  1. Helmneh M. Sineshaw
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  2. Mia Gaudet
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  3. Elizabeth M. Ward
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  7. Ahmedin Jemal
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Correspondence to Helmneh M. Sineshaw.

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Sineshaw, H.M., Gaudet, M., Ward, E.M. et al. Association of race/ethnicity, socioeconomic status, and breast cancer subtypes in the National Cancer Data Base (2010–2011). Breast Cancer Res Treat 145, 753–763 (2014). https://doi.org/10.1007/s10549-014-2976-9

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