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Hormone receptor-positive breast cancer and black race: does sex matter?

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

Abstract

Purpose

Black breast cancer patients have worse clinical outcomes than their White counterparts. There are few studies comparing clinical outcomes between Black male breast cancer (MBC) and female breast cancer (FBC) patients. The objective of this study is to examine differences in presentation, treatment, and mortality between Black MBC and FBC.

Methods

The National Cancer Database was queried for all Black MBC and FBC patients, ages 18–90, with hormone receptor-positive breast cancer diagnosed between 2010 and 2016. Hormone receptor positivity was defined as estrogen receptor-positive, progesterone-positive and HER 2-negative cancer. Sociodemographic and clinical variables were compared between MBC and FBC patients on bivariable analysis. After propensity score matching, overall survival was evaluated using the log-rank test and Cox proportional hazards.

Results

Compared to FBC patients, MBC patients had higher rates of metastatic disease (stage 4, MBC 4.4% vs. FBC 2.6%, p < 0.001), larger tumors (tumor size < 2 cm, MBC 32.1 vs. FBC 49.1%, p < 0.001) and a higher percentage of poorly differentiated tumors (grade 3, MBC 28.5% vs. FBC 21.4%, p < 0.001). MBC patients had lower rates of hormone therapy (MBC 66.4% vs. FBC 80.7%, p < 0.001) and neoadjuvant chemotherapy (MBC 5.8% vs. FBC 7.5%, p = 0.05) than FBC. On propensity score matched analysis, Black MBC patients had a higher overall mortality (p25 of 60 months vs. 74 months) compared to FBC patients (p = 0.0260).

Conclusion

Among hormone receptor-positive Black MBC and FBC patients, there are sex-based disparities in stage, hormone therapy use and overall survival.

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Data availability

The National Cancer Database (NCDB) is a joint project of the Commission on Cancer (CoC) of the American College of Surgeons and the American Cancer Society. The CoC’s NCDB and the hospitals participating in the CoC’s NCDB are the source of the de-identified data used herein; they have not verified and are not responsible for the statistical validity of the data analysis or the conclusions derived by the authors.

Code availability

Not applicable.

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Funding

Samilia Obeng-Gyasi is funded by the Paul Calabresi Career Development Award (K12 CA133250).

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Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, The Ohio State University, N924 Doan Hall, 410 West 10th, Columbus, OH, 43210, USA

    Mariam F. Eskander, Yaming Li, Allan Tsung, Bridget A. Oppong, Ahmad Hamad & Samilia Obeng-Gyasi

  2. Department of Economics, Indiana University Purdue University, Indianapolis, IN, USA

    Oindrila Bhattacharyya

  3. Division of Medical Oncology, Department of Medicine, The Ohio State University, Columbus, OH, USA

    Margaret Gatti-Mays

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  1. Mariam F. Eskander
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  2. Yaming Li
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Contributions

ME, SO-G and YL made contributions to conceptualization, data curation, formal analysis, investigation, writing the original draft and review and editing subsequent drafts. AT, BO, MG-M, AH and OB contributed to the conceptualization, review and editing of the manuscript. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Samilia Obeng-Gyasi.

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Conflict of interest

All the authors that contributed to this work have not conflict of interest to report.

Ethical approval

This research study was conducted retrospectively from a de-identified data obtained. The National Cancer Database (NCDB) is a joint project of the Commission on Cancer (CoC) of the American College of Surgeons and the American Cancer Society. The Ohio State University Office of Responsible Research Practices deemed this study IRB exempt.

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Meeting Presentation: Presented as a poster presentation at the 2020 San Antonio Breast Cancer Symposium, virtual meeting, December 2020.

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Eskander, M.F., Li, Y., Bhattacharyya, O. et al. Hormone receptor-positive breast cancer and black race: does sex matter?. Breast Cancer Res Treat 190, 111–119 (2021). https://doi.org/10.1007/s10549-021-06359-5

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  • DOI: https://doi.org/10.1007/s10549-021-06359-5

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