Abstract P6-09-26: Effect of race on triple negative breast cancer outcomes

Abstract

Abstract Background: African American (AA) women and patients with Triple Negative Breast Cancer (TNBC) have poor outcomes. It is unclear whether these worse outcomes in AA women are due to a higher frequency of TNBC in AA women. The purpose of our study was to determine difference in outcomes between AA and Caucasian (CA) female with TNBC. Methods: A retrospective study of women diagnosed with ER, PR and HER2 (1+) negative breast cancer between January 1/2001 and December 31/2013 at Vidant Medical Center (East Carolina University) in Greenville, North Carolina was undertaken. Patient demographics and tumor characteristics were analyzed to determine impact on overall survival. Results: In our institution, 4,434 women were diagnosed with breast cancer in this study period, of which 378 had TNBC. Our TNBC population was predominantly AA (53%). AA patients were younger (54.1 years vs 58.7 years, p=0.005), less often postmenopausal (62.6% vs 74.5%, p=0.013), more likely to have Medicaid (24.3% vs 7.9%, p <0.001), and to have received chemotherapy (80% vs 69%, p=0.017) compared to CA women. There was no difference in stage at diagnosis between AA and CA patients (p=0.12). By univariate analysis, improved survival in TNBC was associated with non-Medicaid status (p=0.01), early stage at diagnosis (p=0.001), N stage (<0.001), and tumor grade (p<0.001). A Cox regression analysis demonstrated that only insurance status (p=0.007) and N Stage (p=0.01) predicted outcomes in TNBC. Survival in TNBC was not affected by race (p=0.7). Conclusions: Poorer outcomes in AA women cannot be attributed to the higher frequency of TNBC. Improved access to healthcare, with broader insurance coverage, may help minimize disparities in outcome by diagnosing TNBC at an earlier stage.Background: African American (AA) women and patients with Triple Negative Breast Cancer (TNBC) have poor outcomes. It is unclear whether these worse outcomes in AA women are due to a higher frequency of TNBC in AA women. The purpose of our study was to determine difference in outcomes between AA and Caucasian (CA) female with TNBC. Methods: A retrospective study of women diagnosed with ER, PR and HER2 (1+) negative breast cancer between January 1/2001 and December 31/2013 at Vidant Medical Center (East Carolina University) in Greenville, North Carolina was undertaken. Patient demographics and tumor characteristics were analyzed to determine impact on overall survival. Results: In our institution, 4,434 women were diagnosed with breast cancer in this study period, of which 378 had TNBC. Our TNBC population was predominantly AA (53%). AA patients were younger (54.1 years vs 58.7 years, p=0.005), less often postmenopausal (62.6% vs 74.5%, p=0.013), more likely to have Medicaid (24.3% vs 7.9%, p <0.001), and to have received chemotherapy (80% vs 69%, p=0.017) compared to CA women. There was no difference in stage at diagnosis between AA and CA patients (p=0.12). By univariate analysis, improved survival in TNBC was associated with non-Medicaid status (p=0.01), early stage at diagnosis (p=0.001), N stage (<0.001), and tumor grade (p<0.001). A Cox regression analysis demonstrated that only insurance status (p=0.007) and N Stage (p=0.01) predicted outcomes in TNBC. Survival in TNBC was not affected by race (p=0.7). Conclusions: Poorer outcomes in AA women cannot be attributed to the higher frequency of TNBC. Improved access to healthcare, with broader insurance coverage, may help minimize disparities in outcome by diagnosing TNBC at an earlier stage. Citation Format: Mosquera C, Amin R, Wong JH. Effect of race on triple negative breast cancer outcomes [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-09-26.