A Cross-Cultural Consumer-Based Decision Aid for Screening Mammography

The role of acculturation in explaining ethnic differences in the prenatal health-risk behaviors, mental health, and parenting beliefs of Mexican American and European American at-risk women

Background. There is evidence to suggest that early life exposures including birthweight, history of having been breastfed during infancy, in utero exposure to maternal smoking, and parental education are associated with BC risk. Potential underlying mechanisms include variability in exposure to maternal endogenous sex and growth hormones. Also, parental socioeconomic status may be a proxy for environmental characteristics that impact biological processes in early life, and ultimately influence BC risk. Research has focused on EA women; relatively little is known about associations between early life exposures and BC risk for AA women. Methods. We conducted a case-control study in AA and EA women aged 22-75 years living in metropolitan New York City and eastern New Jersey (Women's Circle of Health Study). Breast cancer cases (AA n=827; EA n=772) were diagnosed with primary, incident, histologically confirmed invasive BC or ductal carcinoma in situ. Controls (AA n=905; EA n=715) were frequency matched to cases on age and race. Birthweight, history of having been breastfed during infancy, history of in utero exposure to maternal smoking, and parental education were by self-report using an interviewer-administered questionnaire. Results. Birthweight was not significantly associated with BC risk in this study for AA or EA women. Having been breastfed during infancy was associated with significantly increased BC risk for both groups (ORAA=1.60, 95% Cl: 1.27-2.02; OREA=1.45, 95% Cl: 1.14-1.85). For EA women, but not AA women, reporting in utero exposure to maternal smoking was associated with significantly decreased BC risk (OR=0.61, 95% Cl: 0.45-0.82). Among AA women, those born to mothers with at least a college degree had a significantly lower BC risk compared to AA women born to mothers with a high school or less education (OR=0.67, 95% Cl: 0.49-0.93). Among EA women, we found no association with maternal education. However, EA women born to fathers with at least a college degree had a significantly lower BC risk compared to EA women born to fathers with a high school or less education (OR=0.65, 95% Cl: 0.51-0.84). Conclusions. Our findings support the hypothesis that early life exposures impact adult BC risk. History of having been breastfed during infancy, in utero exposure to maternal smoking, and parental education were all associated with BC risk. While minor differences in risk estimates were found between EA and AA women, associations were similar. Citation Format: Mark L. Glasgow, Jo Freudenheim, Gary Zirpoli, Elisa Bandera, Christine Ambrosone. Early life exposures and breast cancer (BC) risk among African American (AA) and European American (EA) women. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr LB-13. doi:10.1158/1538-7445.AM2013-LB-13

Urinary incontinence in community-dwelling older Mexican American and European American women

Screening mammography is associated with early detection of breast cancer (BC) and reduced BC mortality. To understand factors that influence screening mammography receipt in minority women with unrecognized risk factors for BC, this study examined BC screening behaviors among women with BC. Due to the BC survival disparities observed in African American (AA) and Mexican American (MA) women compared to whites, AA and MA women living in Texas and Arizona who were participants of the ELLA Binational Breast Cancer Study were selected for this study based on a diagnosis of BC. Data on socioeconomic status (SES), reproductive history, family history, insurance status, acculturation, and breast health history were collected via questionnaires and medical record abstraction. 601 women aged 40 years or older at time of BC diagnosis were included in this study, including 270 AA, 151 MA women classified as high-acculturation (MA-HA) and 180 MA women classified as low-acculturation (MA-LA). Logistic regression analysis was used to assess differences in mammography receipt in the last five years prior to BC diagnosis stratified by race/ethnicity and acculturation and for all groups combined. MA women in this study suffer a larger disparity than AA women with regards to screening mammography. Despite high rates of screening mammography among AA and MA women, 62% of BC was self-detected in the study population. AA women (OR=1.0) and MA-HA (OR=0.91; 95% CI: 0.57-1.48) women were more than twice as likely to receive screening mammography compared to MA-LA (OR=0.38; 95% CI: 0.25-0.59), adjusted for age. After adjusting for age, education, and insurance, there was no significant difference in screening mammography receipt between these three groups. Women who had a known family history of BC were more than twice as likely to receive screening mammography than women who had unknown or no family history (OR=2.02; 95% CI: 1.19-3.55). However, although AA and MA-HA women were twice as likely as MA-LA to report a family history of BC (20% vs. 23% vs. 12%, respectively), recognized family history did not account for the differences in screening mammography use between these groups. Thus, the differences observed in screening mammography receipt by race/ethnicity and acculturation among AA, MA-HA, and MA-LA are likely explained by SES variables, including education and insurance. Due to the large proportion of AA and MA women who reported self-detecting their BC, women must be educated about the importance of breast awareness and prompt reporting of findings to a health professional after noticing breast changes. In addition, cancer screening programs targeting underserved women should provide culturally appropriate messages about the importance of knowing their family history and the benefits of screening mammography. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 2806.

Tampon Use in Adolescence: Differences among European American, African American and Latina Women in Practices, Concerns, and Barriers

This research addresses the following 2 questions. What is the effect of childhood and adult economic status on midlife obesity in Mexican American women? How do these economic patterns in Mexican American women compare with patterns seen in White women and in African American women? Data were drawn from the U.S. National Longitudinal Survey of Youths 1979-2002 waves. The sample consisted of 422 Mexican Americans, 2,090 Whites, and 1,195 African Americans. The economic indicator used for childhood economic status was parent education; for adult economic status, the participant's own education and adult per capita income were used. Unadjusted and adjusted odds ratios were estimated for the relationship between midlife obesity and economic indicator, stratified by race/ethnic group. There was an increased risk for midlife obesity with disadvantaged economic status measured during childhood and at midlife in Mexican American women. The economic effects on midlife obesity in Mexican American women were similar to those found for White, but not African American women. Few economic influences on obesity at midlife were found for African American women. Strategies that broadly improve the economic conditions of Mexican American women may be one important way to address the obesity epidemic in this population.

PCN173 - Carbohydrate intake and Breast Cancer risk in African American and European American Women in the Women’s circle of Health Study

2055 Differences in bone mineral density (BMD) between Caucasian and African American women have been well established, however few studies have investigated BMD differences within other ethnic minorities. PURPOSE: The purpose of this study was to investigate differences in BMD between premenopausal Mexican and Asian American women. METHODS: This study recruited 43 premenopausal Mexican American women and 33 Asian American women that live in Los Angeles County. BMD of spine, hip, and body composition were assessed by dual energy x-ray absorptiometry (DEXA). Heel BMD was obtained by a Sahara bone sonometer. Primary risk factors for osteoporosis, cardiovascular (CV) fitness and strength were obtained via a series of questionnaires and by exercise testing in the laboratory. These data were analyzed by independent sample t-test with the level of significance predetermined at p<0.05. RESULTS: Mean age for Mexican Americans and Asian Americans was 36.2 ± 5.0 and 38.7 ± 5.0 years respectively. Mexican Americans had significantly higher body weight (67.7 ± 13.2 kg vs. 56.2 ± 6 kg), lean body mass (43.6 ± 6 kg vs. 39 ± 3.8 kg), and percent body fat (33.2% vs. 27.9%) compared to Asian Americans. There were no significant differences in BMD or t-scores at all sites measured. In addition there were no differences in CV fitness or any of the strength measures. Asian America women reported greater frequency of smoking and drinking alcohol than Mexican American women as well as significantly higher income (p = 0.013), leisure walking index (p = 0.045), but significantly lower oral contraceptive use (p = 0.000) and number of children (p = 0.014). CONCLUSIONS: These data show that BMD of premenopausal Asian American women is similar to Mexican American women. However, lifestyle predictors of BMD were different providing some insight into differences in lifetime risk of osteoporosis. Supported by NIH Grant S06 GM 8101–28

Background: Human endogenous retroviruses (HERVs) are remnants of ancient virus infection. The majority of them are disabled due to mutation and/or deletion. However, HERV K113 and K115 have been shown to have full-length insertion in human genome and retain the ability to encode functional virus proteins in some individuals. Considering the potential role of HERVs in carcinogenesis and a high genetic homology between HERV K and mouse mammary tumor virus, the study is designed to investigate the distribution of HERV K113 and K115 in African American (AA) and European American (EA) women, and their association with breast cancer risk. Methods: Built on a funded multi-center case-control study, the Women's Circle of Health Study, the study included 1242 cases (608 AA and 634 EA) and 1422 controls (783 AA and 639 EA). PCR followed by fragment analysis was used for insertional polymorphism assay. For each HERV, three PCRs were performed to determine whether the insertion is partial or full length. Indeed, a subset of individuals showed insertion of long terminal repeat (LTR) of HERV, instead of whole virus insertion. The distribution of insertional polymorphisms was compared between AA and EA as well as between cases and controls. Logistic regression was used to calculate odds ratio (OR) and 95% confidence interval (CI) with adjustment for age at diagnosis and proportion of European ancestry. Results: For both K113 and K115, with or without including LTR insertion, the distribution was significantly different between AA and EA women. A two-fold higher prevalence of HERVs was observed in AA women, showing 51.5% of individuals with at least one copy of either K113 or K115 compared to 23.3% in EA women among controls. The prevalence of HERVs was inversely associated with proportions of European ancestry, showing a decrease from averagely 66% European ancestry in individuals without insertion to 42.9%, 23.2%, 13.3% with one, two, or more insertions of HERV K113 or K115, respectively. Between cases and controls, the prevalence of K113 was slightly higher in controls, but not for K115. Furthermore, both K113 and K115 insertion were significantly associated with the reduced risk of breast cancer in both AA and EA women. Near 50% reduction of breast cancer risk was observed in AA and EA women with homozygous insertion of K113 (combined OR, 0.45; 95% CI, 0.25-0.80). A trend of a reduction in breast cancer risk with an increase of copy number of HERV K insertion was observed in both AA and EA women. However, there was no association with breast cancer subtypes. Conclusion: This is the first study to document the prevalence of HERV K113 and K115 in AA and EA population, and to report an inverse association with breast cancer risk. Validation of the findings in a relatively large study is warranted in the future. Funded by 5R03CA156645, K07CA148888, P01151135, and R01CA100598. Citation Format: Li Tang, Steven R. Gregory, David Tritchler, Gary R. Zirpoli, Song Yao, Warren Davis, Gregory L. Ciupak, Yasmin Thanavala, Elisa V. Bandera, Christine B. Ambrosone. Associations between insertional polymorphisms of human endogenous retrovirus K113 and K115 and breast cancer risk in African American and European American women. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 2789. doi:10.1158/1538-7445.AM2015-2789

African American (AA) women are more likely than European American (EA) women to be diagnosed with early, aggressive breast cancer. Possible differences in innate immune pathways (e.g., inflammatory responses) have received little attention as potential mechanisms underlying this disparity. We evaluated distributions of selected genetic variants in innate immune pathways in AA and EA women, and examined their associations with breast cancer risk within the Women’s Circle of Health Study (WCHS). In stage I of the study (864 AA and 650 EA women) we found that genotype frequencies for 35 of 42 tested SNPs (18 candidate genes) differed between AAs and EAs (corroborated by ancestry informative markers). Among premenopausal AA women, comparing variant allele carriers to non-carriers, reduced breast cancer risk was associated with CXCL5-rs425535 (OR=0.61, P=0.02), while among EA women, there were associations with TNFA-rs1799724 (OR =2.31, P =0.002) and CRP-rs1205 (OR=0.54, P=0.01). For postmenopausal women, IL1B-rs1143627 (OR=1.80, P=0.02) and IL1B-rs16944 (OR=1.85, P =0.02) were associated with risk among EA women, with significant associations for TNFA-rs1799724 limited to estrogen receptor (ER) positive cancers (OR=2.0, P =0.001). However, none of the SNPs retained significance after Bonferroni adjustment for multiple testing at the level of P0.0012 (0.05/42) except for TNFA-rs1799724 in ER positive cancers. In a stage II validation (1,365 AA and 1,307 EA women), we extended evaluations for four SNPs (CCL2-rs4586, CRP-rs1205, CXCL5-rs425535, and IL1RN-rs4251961), which yielded similar results. In summary, distributions of variants in genes involved in innate immune pathways were found to differ between AA and EA populations, and showed differential associations with breast cancer according to menopausal or ER status. These results suggest that immune adaptations suited to ancestral environments may differentially influence breast cancer risk among EA and AA women.

Compared to European American (EA) women, African American (AA) women have higher rates of estrogen receptor negative (ER-) breast cancer, more specifically triple-negative (TN) subtype, and show poorer prognosis and survival. Increasing evidence suggests biological differences may contribute to the observed racial disparity. Studies evaluating racial differences in gene expression in breast tumor tissue have reported inconsistent results. Study of normal breast tissue in healthy women may provide new insight into biological mechanisms for cancer development prospectively before tumor occurrence. However, racial influence on gene expression in normal breast tissue has not been extensively studied. In this study, we evaluated racial differences in gene expression in normal breast tissue obtained from 23 healthy women as well as tumor tissue obtained from 108 breast cancer patients. We analyzed RNA-sequencing data and performed differential expression analysis between AA and EA women. We found that differentially expressed genes in normal breast tissue between AA and EA women were enriched in biological pathways related to amino acid metabolism, immune response and signaling, lipid and protein biosynthesis, and cell proliferation and survival. Many of these biological differences persist in tumor tissue between EA and AA women in a subtype-specific manner. For example, in ER- breast cancer, racial differences in gene expression were enriched in amino acid metabolism, cell proliferation and survival pathways, with particular enrichment in immune response and signaling and lipid metabolism pathways in TN breast cancer. For ER+ breast cancer, we did not find any major biological pathway enrichment. In addition, we identified several microRNAs differentially expressed in normal breast tissue between EA and AA women. They may be involved in racial differences in breast carcinogenesis but their potential downstream effects are yet to be determined. Future studies are needed to validate our findings and understand racial-specific biological mechanisms in breast cancer development. Citation Format: Aditi Shendre, Yunlong Liu, Anna Maria Storniolo, Bryan P. Schneider, Jiali Han, Chunyan He. Biological differences underlying racial disparity in breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr LB-163. doi:10.1158/1538-7445.AM2017-LB-163

Background: Although European American (EA) women have higher incidence of breast cancer than African American (AA) women, AA women are more often diagnosed with aggressive estrogen receptor negative (ER-) tumors, the risk of which increases with parity, lack of breastfeeding, and an early age at menarche. DNA methylation could be affected by reproductive factors and may be a potential molecular mechanism driving differences in tumor etiology. In a small study using fresh frozen breast tissue (n=58 AA, 80 EA), we previously found more differentially methylated loci (DMLs) in ER- tumors from AA and EA women than in ER+ tumors. Methods: To follow up on these preliminary findings, we used the Illumina 450K platform to determine genome-wide DNA methylation profiles in formalin fixed paraffin embedded (FFPE) breast tumors from 383 AA and 350 EA women who participated in the Women's Circle of Health Study, a case control study conducted in NY and NJ. We identified DMLs by race and ER status, as well as differentially methylated regions (DMRs). DMLs in eight genes were validated using the Sequenom EpiTYPER platform. Recursively partitioned mixture modeling (RPMM) package in R was used to examine relationships between methylation clusters and reproductive factors, information available from in-person interviews. In addition, using fresh frozen tumor tissue from 50 patients treated at Roswell Park Cancer Institute, we performed RNA sequencing on samples with methylation data available from a prior study, and used Spearmen's correlation to compare methylation and gene expression of DMLs and DMRs. Results: In assessing average methylation by location relative to CpG-islands (CGIs), we found that CGIs and shores in ER- tumors were significantly hypomethylated compared to CGI and shores in ER+ tumors from AA women, but not in tumors from EA women. We also identified 410 DMLs (Δβ&amp;gt;0.10 &amp; FDR&amp;lt;0.05) between AA and EA breast tumors (race-associated DMLs, raDMLs), the majority of which were unique to ER- tumors (n = 260) and hypomethylated in AAs. These loci were enriched for immune response genes and several cell adhesion and inflammatory pathways. RPMM showed that parity, but not breastfeeding or age at menarche, was significantly associated with methylation class of ER- breast tumors. Of the genes that had ER- specific raDMLs, FOXA1 and THSD4 DNA methylation was highly correlated with gene expression (rho=-0.80, rho=+0.87, respectively; pvalue&amp;lt; 2.2x10-16). Summary: ER- tumors from AA women, but not from EA women, exhibited global hypomethylation at CGI and shores compared to ER+ tumors and contained the majority of raDMLs, many of which were associated with genes involved in immune and inflammatory response. The FOXA1 gene, which encodes a pioneer factor previously implicated in suppressing the molecular phenotype of basal breast cancer cells, was found to be methylated and silenced in the majority of ER- tumors analyzed for expression, consistent with aggressiveness of these tumors. These results, and the novel finding of associations between parity and DNA methylation signature, bring us a step forward in understanding the heterogeneous population of ER- tumors and provide insight into mechanisms of racial disparities in breast cancer. Citation Format: Allyson C. Espinal, Dan Wang, Lara Sucheston-Campbell, Song Liu, Qiang Hu, Li Tang, Gary Zirpoli, Thaer Khoury, Song Yao, Kitaw Demissie, Elisa V. Bandera, Christine B. Ambrosone, Michael J. Higgins. Methylation differences in breast tumor DNA from African American and European women are predominant in estrogen receptor (ER) negative breast cancer and are associated with childbearing. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr B47.

Racial disparity in breast cancer is well recognized. Compared to European American (EA) women, African American (AA) women are more often diagnosed with breast cancer at younger ages, have a more advanced or aggressive disease, and have poorer outcomes. Increasing evidence suggests that biological differences between EA and AA women, particularly differences in epigenetic changes of DNA methylation (DNAm), may contribute to the observed cancer disparity. We hypothesize that racial differences in DNAm in normal breast tissue may reflect distinct genomic susceptibility to breast cancer in different racial groups. Therefore, we investigated epigenome-wide differences of DNAm in normal breast tissue between 178 EA and 272 AA women using the Illumina TruSeq Methyl Capture EPIC library and NGS technology. We identified 17,340 differentially methylated CpG loci (DMLs) between EA and AA women, of which 7,744 were hypermethylated in AA women and 9,596 were hypermethylated in EA women. Pathway analyses of genes annotated to these racial DMLs suggested enrichment of biological processes including cell movement, cell motility, and cell migration, features that are likely linked to the aggressiveness and metastatic potentials of tumor cells. We further examined racial differences in DNAm of breast cancer-related candidate genes and GWAS-identified breast cancer risk loci. Approximately 30% of candidate genes were found to have racial differences in DNAm at more than three CpG sites and these candidate genes were enriched for pathways related to response to stimulus and anatomic structure development. Most interestingly, racial DMLs were found to be enriched for breast cancer risk loci that are associated with risk of estrogen-receptor negative (ER-) breast cancer, treatment response to aromatase inhibitor, and breast cancer-specific morality, phenotypes of which we observed differences between EA and AA breast cancer patients. Our results suggest that racial differences in DNAm in normal breast tissue may induce different biological processes that lead to distinct clinical features of breast tumors observed in EA and AA women and provide an epigenetic mechanism underlying the observed racial disparities. Further research is need to validate the findings of this study. Citation Format: Nan Lin, James Castle, Jinpeng Liu, Chunyan He. Racial differences of epigenome in normal breast tissue reveal biological pathways implicated in racial disparities in breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1937.

Objective: To compare trends in the prevalence of metabolic syndrome (MetS) by race/ethnicity among US women ages 18-49 years between 1988 and 2016. Methods: Using data from the National Health and Nutrition Examination Survey (NHANES), we classified MetS according to AHA/NHLBI criteria and calculated age-standardized prevalence of MetS in the following periods: 1988-94, 1999-04, 2005-10, and 2011-16. Our sample included nonpregnant women 18-49 years of age who self-reported as non-Hispanic White, non-Hispanic Black, or Mexican American. For each period, we estimated relative (prevalence ratio, PR) and absolute (prevalence difference, PD) differences by race/ethnicity. We tested heterogeneity of these estimates using ANOVA to determine if the differences between groups significantly widened or narrowed over time. All analyses were stratified by gravidity (nulligravida vs. primi- and multigravida). Results: Between 1988-94 and 2011-16, the age-standardized prevalence of MetS for nulligravida and primi-/multigravida women increased from 10% to 19% and 16% to 28%, respectively. Among nulligravida women , the relative differences in MetS between NH Black and NH White women decreased (PR 1988-94 =1.6, PR 1999-04 =1.4, PR 2005-10 =1.4, PR 2011-16 =1.0), while the difference between Mexican American and NH White women declined in 1999-04, but increased after (PR 1988-94 =2.2, PR 1999-04 =1.0, PR 2005-10 =1.5, PR 2011-16 =1.7). Compared to NH White women, the absolute differences for NH Black (PD 1988-94 =5.8%, PD 1999-04 =9.2%, PD 2005-10 =7.5%, PD 2011-16 =-0.5%) and Mexican American women (PD 1988-94 =11.1%, PD 1999-04 =-0.2%, PD 2005-10 =9.3%, PD 2011-16 =11.9%) followed similar patterns. Moreover, and among primi-/multigravida women , the relative differences between NH Black and NH White women remained stable (PR 1988-94 =1.3, PR 1999-04 =1.3, PR 2005-10 =1.5, PR 2011-16 =1.3), while the differences between Mexican American and NH White women declined (PR 1988-94 =1.8, PR 1999-04 =1.6, PR 2005-10 =1.3, PR 2011-16 =1.3). Again, compared to NH White women, absolute differences for NH Black (PD 1988-94 =4.4, PD 1999-04 =8.5, PD 2005-10 =10.7, PD 2011-16 =7.0) and Mexican American women (PD 1988-94 =12.2, PD 1999-04 =15.4, PD 2005-10 =5.7, PD 2011-16 =7.1) were similar. We found no evidence of significant heterogeneity of PRs and PDs across time for any group. Conclusions: Since 1988, prevalence of MetS among US women ages 18-49 has nearly doubled. The increase in prevalence was similar across NH White, NH Black and Mexican American women. Among nulligravida women, those that self-reported as Mexican American had the highest burden of MetS, while among primi-/multigravida women, the prevalence of MetS was consistently higher among both Mexican American and non-Hispanic Blacks.

Purpose of study: Female breast cancer is the second leading cause of cancer death in U.S. women, and the incidence of new breast cancer cases continues to increase. Despite slightly lower breast cancer incidence rates among African American (AA) compared to European American (EA) women in the U.S., AA women experience significantly higher breast cancer mortality. To better understand the extent to which environmental and genetic factors might help explain higher mortality rates among AA women, we examined the association between a measure of exposure to chemical pollutants and genomic profiling with breast cancer mortality among women with breast cancer in North Carolina. Procedures: Using a molecular epidemiologic approach, we examined the association of county hog concentration (a marker of environmental exposure to chemical pollutants) and genomic variations identified via targeted exome sequencing with age-adjusted breast cancer mortality rates among 146 women in North Carolina, stratified by race (AA vs. EA). The odds of breast cancer-specific mortality were estimated as a function of county hog concentration quintiles. Results: Overall, breast cancer mortality among AA women was higher than among EA women (OR=1.4, p&amp;lt;0.0001). Although there was no effect of hog concentration on breast cancer mortality of EA women, there was an increase in deaths from breast cancer in African American women in the highest quintile of hog concentration (OR=1.18, p=0.03), compared to the lower quintiles. In the lowest quintile of hog concentration, breast cancer mortality remained higher among AA versus EA women (OR=1.38, p=0.0002). This suggests that along with environmental factors, biological factors also contribute to disparities. Next, we performed targeted exome sequencing of breast cancer samples collected from a cohort in eastern North Carolina. AA breast cancer samples showed a high frequency of CNVs (copy number variations) of COL11A2, COL12A1, CYP21A2, LYRM2, COL9A1, DNAH11, and DST. EA breast cancer samples showed a high frequency of CNVs of PRG4, PLB1, CHRM5, OCA2, HMCN1, and MUC5B. Among these, HMCN1, MUC5B (among EA), and COL12A1, DNAH11, DST (among AA) were genes with significantly high CNVs identified from The Cancer Genome Atlas. Conclusions: Our findings suggest that living in a county with a high concentration of hogs may increase breast cancer mortality risk among AA women, and the high frequency of CNVs varies by race; both CNV and county hog concentration may contribute to racial disparities in breast cancer mortality among AA and EA women in North Carolina. Citation Format: Jung S. Byun, Sean Lee, Sijung Yun, Eliseo J. Perez-Stable, Anna M. Napoles, Paul Strickland, Kevin L. Gardner. Race, copy number variation, and local hog concentration in breast cancer mortality [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 1183.