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Asian ethnicity and breast cancer subtypes: a study from the California Cancer Registry

  • Epidemiology
  • Published:
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Abstract

The distribution of breast cancer molecular subtypes has been shown to vary by race/ethnicity, highlighting the importance of host factors in breast tumor biology. We undertook the current analysis to determine population-based distributions of breast cancer subtypes among six ethnic Asian groups in California. We defined immunohistochemical (IHC) surrogates for each breast cancer subtype among Chinese, Japanese, Filipina, Korean, Vietnamese, and South Asian patients diagnosed with incident, primary, invasive breast cancer between 2002 and 2007 in the California Cancer Registry as: hormone receptor-positive (HR+)/HER2− [estrogen receptor-positive (ER+) and/or progesterone receptor-positive (PR+), human epidermal growth factor receptor 2-negative (HER2−)], triple-negative (ER−, PR−, and HER2−), and HER2-positive (ER±, PR±, and HER2+). We calculated frequencies of breast cancer subtypes among Asian ethnic groups and evaluated their associations with clinical and demographic factors. Complete IHC data were available for 8,140 Asian women. Compared to non-Hispanic White women, Korean [odds ratio (OR) = 1.8, 95% confidence interval (CI) = 1.5–2.2], Filipina (OR = 1.3, 95% CI = 1.2–1.5), Vietnamese (OR = 1.3, 95% CI = 1.1–1.6), and Chinese (OR = 1.1, 95% CI = 1.0–1.3) women had a significantly increased risk of being diagnosed with HER2-positive breast cancer subtypes after adjusting for age, stage, grade, socioeconomic status, histology, diagnosis year, nativity, and hospital ownership status. We report a significant ethnic disparity in HER2-positive breast cancer in a large population-based cohort enriched for Asian-Americans. Given the poor prognosis and high treatment costs of HER2-positive breast cancer, our results have implications for healthcare resource utilization, cancer biology, and clinical care.

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Funding acknowledgments

This study was supported by grants from the National Cancer Institute of the National Institutes of Health (N01-PC-35136 and N02-PC-15105), and Centers for Disease Control and Prevention, National Program of Cancer Registries (U55/CCR921930-02).

Conflict of interest

All authors report no financial conflicts of interest related to this study. The authors have full control of the primary data and agree to allow Breast Cancer Research and Treatment to review that data if requested.

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Authors and Affiliations

  1. Division of Medical Oncology, Department of Medicine, Stanford University School of Medicine, 875 Blake Wilbur Drive, Stanford, CA, 94305, USA

    Melinda L. Telli, Allison W. Kurian & James M. Ford

  2. Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA

    Ellen T. Chang, Allison W. Kurian, Theresa H. M. Keegan & Scarlett L. Gomez

  3. Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA

    James M. Ford

  4. Cancer Prevention Institute of California, Fremont, CA, USA

    Ellen T. Chang, Theresa H. M. Keegan, Laura A. McClure, Daphne Lichtensztajn & Scarlett L. Gomez

Authors
  1. Melinda L. Telli
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  2. Ellen T. Chang
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  3. Allison W. Kurian
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  4. Theresa H. M. Keegan
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  8. Scarlett L. Gomez
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Correspondence to Melinda L. Telli.

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Telli, M.L., Chang, E.T., Kurian, A.W. et al. Asian ethnicity and breast cancer subtypes: a study from the California Cancer Registry. Breast Cancer Res Treat 127, 471–478 (2011). https://doi.org/10.1007/s10549-010-1173-8

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  • DOI: https://doi.org/10.1007/s10549-010-1173-8

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