Abstract
Latina women in the U.S. have relatively low breast cancer incidence compared to Non-Latina White (NLW) or African American women but are more likely to be diagnosed with the more aggressive “triple negative” breast cancer (TNBC). Latinos in the U.S. are a heterogeneous group originating from different countries with different cultural and ancestral backgrounds. Little is known about the distribution of tumor subtypes in Latin American regions. Clinical records of 303 female Peruvian patients, from the Peruvian National Cancer Institute, were analyzed. Participants were diagnosed with invasive breast cancer between 2010 and 2015 and were identified as residing in either the Selva or Sierra region. We used Fisher’s exact test for proportions and multivariable Cox Proportional Hazards Models to compare overall survival between regions. Women from the Selva region were more likely to be diagnosed with TNBC than women from the Sierra region (31% vs. 14%, p = 0.01). In the unadjusted Cox model, the hazard of mortality was 1.7 times higher in women from the Selva than the Sierra (p = 0.025); this survival difference appeared to be largely explained by differences in the prevalence of TNBC. Our results suggest that the distribution of breast cancer subtypes differs between highly Indigenous American women from two regions of Peru. Disentangling the factors that contribute to this difference will add valuable information to better target prevention and treatment efforts in Peru and improve our understanding of TNBC among all women. This study demonstrates the need for larger datasets of Latin American patients to address differences between Latino subpopulations and optimize targeted prevention and treatment.
Highlights
Latina women in the U.S have a relatively low breast cancer incidence compared to NonLatina White (NLW) or African American women [1]
Prior to adjustment for patient characteristics, women from the Selva region were more likely to be diagnosed with triple negative” breast cancer (TNBC) (31% vs. 17%, prevalence difference (PD) = 0.14, 95% CI: 0.02, 0.27, p = 0.01); after adjustment for age and stage at diagnosis the corresponding PD was 0.14
The present analysis showed that the incidence of TNBC differs between Indigenous American women who live in the Selva (28%) and Sierra regions of Peru (15%) and that women from the Selva region have a lower probability of survival
Summary
We obtained data from INEN (Instituto Nacional de Enfermedades Neoplasicas) on 303 female Peruvian patients who were diagnosed with invasive breast cancer between 2010 and 2015 and who were identified as residing in areas populated by Indigenous American groups from two geographical regions: Selva and Sierra (Fig 1). Patient demographic and clinical information included age at diagnosis, birthplace, place of residence, survival status (based on periodically updated information from the Registro Nacional de Identificacion y Estado Civil (RENIEC)), stage, subtype, laterality, surgery, chemotherapy, and radiation treatment, all of which were abstracted from an already existing database at INEN and anonymized before analysis. Prevalence’s were adjusted by age at diagnosis (categorized as
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