Does race affect outcomes in triple negative breast cancer (TNBC)?

Abstract

e17543 Background: TNBC is associated with a worse prognosis than luminal subtypes. There is discordance among studies assessing the impact of race on outcomes of TNBC. Our objective was to assess whether African American (AA) vs. Caucasian (CA) race predicted survival outcomes for women with TNBC treated at a single institution in Memphis, TN. Secondary objectives were to examine the association of race with patient and tumor characteristics. Methods: Patients with stage I-III TNBC were identified from our breast cancer database and confirmed by review of pathology reports. Event free survival (EFS) was measured from the date of surgery to the date of first recurrence (locoregional, distant, or contralateral), death from breast cancer or last follow-up. Breast cancer specific survival (BCSS) was measured from the date of surgery to the date of death from breast cancer or last follow-up. Fisher's exact test was used for association between variables, Kaplan Meier method for survival estimates, and log rank test for survival comparison between groups (p < 0.05: significant). Cox proportional hazards models with patient, tumor and treatment variables were fitted for EFS and BCSS. Results: Of the 105 patients with TNBC, 71% were AA. There was no significant association between race and stage at diagnosis (p = 0.68). 71% of AA women were < 55 years old and 43% were pre-menopausal vs. 50% and 23% of CA women respectively. There was a trend towards association of race with age and menopausal status (p = 0.08). Ninety three percent of the patients received neo/adjuvant chemotherapy. With a median follow up of 26 months, 26% of AA vs. 20% of CA women had an event (p = 0.62). Overall 3 year EFS and BCSS estimates were 69% and 82% respectively. Racial differences in EFS and BCSS for AA vs. CA (65% vs. 80% and 78% vs. 89%, respectively) did not achieve statistical significance (log rank p = 0.22 for EFS and 0.26 for BCSS). Race was not a significant predictor of EFS or BCSS on uni-variable or multi-variable analysis. Stage at diagnosis retained significance for EFS and BCSS on uni-variable and multi-variable testing. Conclusions: Race did not affect outcomes in our cohort of TNBC patients treated similarly. The high event rate underscores the poor prognosis of TNBC and the need for more effective therapies. No significant financial relationships to disclose.