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Racial disparities in risk of second breast tumors after ductal carcinoma in situ

  • Epidemiology
  • Published:
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Abstract

The purpose of the study was to examine the impact of race/ethnicity on second breast tumors among women with ductal carcinoma in situ (DCIS). We identified 102,489 women diagnosed with primary DCIS between 1988 and 2009 from the 18 NCI-SEER Registries. Cox proportional hazard regression was used to estimate race/ethnicity-associated relative risks (RRs) and their 95 % confidence intervals (CI) of ipsilateral breast tumors (IBT; defined as DCIS or invasive carcinoma in the ipsilateral breast) and contralateral breast tumors (CBT; defined as DCIS or invasive carcinoma in the contralateral breast). Overall, 2,925 women had IBT and 3,723 had CBT. Compared with white women, black (RR 1.46; 95 % CI 1.29–1.65), and Hispanic (RR 1.18; 95 % CI 1.03–1.36) women had higher IBT risk, which was similar for invasive IBT and ipsilateral DCIS. A significant increase in IBT risk among black women persisted, regardless of age at diagnosis, treatment, tumor grade, tumor size, and histology. The CBT risk was significantly increased among black (RR 1.21; 95 % CI 1.08–1.36) and Asian/PI (RR 1.16; 95 % CI 1.02–1.31) women compared with white women. The association was stronger for invasive CBT among black women and for contralateral DCIS among Asian/PI women (P heterogeneity < 0.0001). The black race-associated CBT risk was more pronounced among women ≥50 years at diagnosis and those with comedo DCIS; in contrast, a significant increase in risk among Asian/PI women was restricted to those <50 years and those with noncomedo DCIS. Racial/ethnic differences in risks of second breast tumors after DCIS could not be explained by pathologic features and treatment.

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Acknowledgments

Y. L. was supported by the Barnes-Jewish Hospital Foundation, St. Louis, Missouri. G. A. C. was also supported by the Breast Cancer Research Foundation. M. S. G was supported by the Barnes-Jewish Hospital Foundation, Siteman Cancer Center, National Institutes of Health, National Cancer Institute Grant U54CA153460, and Washington University School of Medicine Faculty Diversity Scholars Program. The funding agency had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.

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Authors and Affiliations

  1. Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 South Euclid Ave, Campus Box 8100, St. Louis, MO, 63110, USA

    Ying Liu, Graham A. Colditz & Melody Goodman

  2. Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO, USA

    Graham A. Colditz, Sarah Gehlert & Melody Goodman

  3. The Brown School, Washington University, St. Louis, MO, USA

    Sarah Gehlert

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  1. Ying Liu
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Correspondence to Ying Liu.

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Liu, Y., Colditz, G.A., Gehlert, S. et al. Racial disparities in risk of second breast tumors after ductal carcinoma in situ. Breast Cancer Res Treat 148, 163–173 (2014). https://doi.org/10.1007/s10549-014-3151-z

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