Minority women more likely to develop aggressive breast cancer.

Abstract

Disparities in breast cancer continue to occur in all subtypes and stages of the disease, according to the results of a recent study.1 The study, led by Lu Chen, MPH, a researcher in the public health sciences division at Fred Hutchinson Cancer Research Center in Seattle, Washington, found that minority women were more likely to have aggressive subtypes of breast cancer and also were more likely to receive non guideline-concordant treatment when compared with non-Hispanic white women. Chen notes that previous studies have addressed breast cancer disparities by stage of disease and survival rates but did not characterize them by subtypes, which is why she and her colleagues decided to focus on them. They found a consistent pattern of late diagnosis and not receiving recommended treatment for some racial and ethnic groups across all breast cancer subtypes. Researchers analyzed data from 18 US population-based cancer registries participating in the NCI's Surveillance, Epidemiology, and End Results program. From these data, they gleaned detailed demographic and medical information regarding 102,064 women, including patient tumor subtypes, hormone receptor status, and human epidermal growth factor receptor 2 (HER2) status. Results demonstrated that, compared with non-Hispanic white women, African American women were 30% to 60% more likely to receive non guideline-concordant (inappropriate) treatment across all breast cancer subtypes except hormone receptor-negative/HER2-positive disease and that Hispanic women were 20% to 40% more likely to receive inappropriate treatment. Asian and Pacific Islander women demonstrated no disparity with non-Hispanic white patients in receipt of guideline-concordant treatment. These disparities persisted even after adjusting for insurance status, Chen says. Women in the study who were reported to have “non guidelineconcordant treatment” may have received surgery only rather than radiotherapy after undergoing breast-conserving surgery. It is likely that both socioeconomic factors and access to care could be driving inappropriate treatment, according to other studies. Chen points to the need for targeted, culturally appropriate interventions in breast cancer screening and care to reduce these disparities.