Abstract
Abstract Background: African-American women with hormone receptor positive breast cancer have an inferior survival compared to Caucasians (Sparano, et al (SABCS, 2009, Abstract #37) and Albain, et al (ASCO, 2010, Abstract #511)). It is not clear whether this difference is a result of disparities in access to care and stage at presentation or biological factors. We sought to examine whether African-American women with early-stage hormonereceptor positive breast cancer had a higher risk of recurrence than similarly staged Caucasians using a standard clinicopathologic risk prediction algorithm (AdjuvantOnline!) and a biologic risk prediction algorithm (Oncotype DX). Materials and Methods: Women with early stage, hormone receptor positive, Her2 normal, lymph node negative breast cancer seen at the University of Tennessee Cancer Institute between 2007-2009 were retrospectively reviewed. All patients had an AdjuvantOnline! recurrence risk calculated. For patients in whom an Oncotype DX was available, differences in risk of recurrence between clinicopathologic and biologic algorithms were evaluated with respect to race (African-American versus Caucasian). Results: 96 women were identified, 38 of whom were African-American and 58 of whom were Caucasian. 50 women had an Oncotype DX available. Clinicopathologic factors were well-balanced between the groups (see Table 1). Using AdjuvantOnline!, there was no significant difference between African-American and Caucasian patients in their average risk of recurrence (25% versus 23%, P=0.15). Using Oncotype DX, there was similarly no significant difference in the average risk of recurrence by race (18.6% for African-American versus 18.9% for Caucasian, P=0.55). Patient Characteristics Grade was not available for 1 Caucasian patient. Discussion: When matched for stage and general clinicopathologic factors (hormone receptor positivity, Her2 normal, lymph node negative), African-American and Caucasian patients have similar risk of recurrence using AdjuvantOnline! and Oncotype DX, though the expected risk was somewhat lower with Oncotype DX in both groups. This would suggest that there may be little biologic difference between African-American and Caucasian women with early stage hormone receptor positive breast cancer and that any difference in survival is likely related to non-biological factors. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-13-07.
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