Abstract B66: Breast cancer outcomes among Hispanic women by race

Abstract

Abstract Introduction: Few studies have examined the distribution of breast cancer outcomes among Hispanics by race (i.e. Hispanic Black, Hispanic White). Understanding the diversity of breast cancer characteristics among Hispanic women is key to explaining the differences in breast cancer outcomes. Purpose: To assess the distribution of tumor stage, joint estrogen receptor (ER)/progesterone receptor (PR) status, and breast cancer-specific mortality with race and ethnicity, among Hispanic Black, Hispanic White, non-Hispanic Black (NHB), non-Hispanic White (NHW) women using Surveillance, Epidemiology, and End Results (SEER) Program data. Methods: We used data on 441,742 women aged 20–79 years who were diagnosed with primary invasive breast cancer between January 1992 and December 2008, with no prior history of cancer, and who were identified through the SEER 17 population-based registries. Women less than 20 and older than 79 years of age were excluded from the study. The primary outcomes of interest were: AJCC tumor stage, joint estrogen receptor (ER)/progesterone receptor (PR) status, and breast cancer-specific mortality. Our primary exposure of interest was race/ethnicity, which was categorized into four groups, based on SEER data: non-Hispanic White, non-Hispanic Black, Hispanic White, and Hispanic Black. Covariates included age at diagnosis, year of diagnosis, % population below poverty level, % population with less than a high school education, % foreign born, % non-English language, SEER registry, and treatment (surgery and/or radiation therapy). Results: Hispanic Blacks had the highest risk of being diagnosed with stage III and IV tumors compared to NHWs (RRR=2.4 [95% CI:1.9-3.1] and RRR=2.0 [95% CI:1.4-2.8], respectively; p<0.01). Both NHBs and Hispanic Blacks had 2.4-fold greater risk of being diagnosed with ER–/PR– breast cancer compared to NHW women (RRR=2.4 [95% CI:2.3-2.5] and RRR=2.4 [95% CI:2.0-2.9], respectively; p<0.01). Hispanic White women had a significantly increased risk of being diagnosed with both ER–/PR– (64% increase) and ER+/PR– (24% increase) breast cancers compared to NHW women (RRR=1.6 [95% CI:1.6-1.7] and RRR=1.2 [95% CI:1.2-1.3], respectively; p<0.01). Hispanic White and Hispanic Black women were at increased risk of breast cancer-specific mortality compared to NHW women (HR=1.2 [95% CI:1.2-1.3] and HR=1.5 [95%:1.2-1.80, respectively, p<0.01). Conclusion: Hispanic Black women have disproportionately higher rates of late stage invasive breast cancer diagnoses, ER–/PR– breast disease, and breast cancer-specific mortality compared to non-Hispanic White women. Furthermore, RRR estimates suggest that the increased risk associated with late stage and ER–/PR– may be greater than or equal to those estimates observed for non-Hispanic Black and Hispanic White women. The findings from this study will be among the first studies to present information on breast cancer characteristics and outcomes in both Hispanic Black and Hispanic White. Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):B66.