Abstract
139 Background: Racial/ethnic disparities in breast cancer survival have been well-documented. Trastuzumab was FDA approved for adjuvant treatment of HER2-positive breast cancer in November, 2006 and has improved survival in these patients. The purpose of this study is to determine if racial disparities have changed in patients who were diagnosed with HER2 positive breast cancer in 2007-2012 when compared with patients who were diagnosed in 2000-2006. Methods: Using the California Cancer Registry, we identified 32,597 cases of first primary female invasive HER2-postive breast cancer. Cases were divided into two cohorts: Early - diagnosed in 2000-2006; Late - diagnosed in 2007-2012. Kaplan-Meier 6-year survival and Cox regression analysis was conducted to assess risk of mortality of African Americans, Hispanics, Asian/Pacific Islanders, and American Indians when compared with whites. Analyses were conducted separately for each cohort and adjusted for stage at diagnosis, grade, age, and socioeconomic status. Hazard ratios and 95% confidence intervals were reported. Use of trastuzumab was not documented. Results: When combining all HER2-positive subtypes (ER+/PR+/HER2+, ER-/PR+/HER2+, ER+/PR-/HER2+, ER-/PR-/HER2+), blacks had an increased risk of mortality (HR = 1.32; 95% CI: 1.16-1.49), in the early cohort but there were no differences for any other race. There were no differences in mortality by race/ethnicity in the late cohort. Separation of the HER2-positive subtypes showed that African Americans with the ER+/PR+/HER2+ subtype had higher mortality than whites (HR = 1.43; 95% CI: 1.17-1.75) in the early cohort but there was no difference in the late cohort. There were no racial disparities within either of the cohorts for the ER-/PR-/HER2+ subtype. Conclusions: Although we were unable to document use of anti-HER2 treatment, the era of adjuvant trastuzumab appears to have attenuated the black/white disparity in HER2 positive breast cancer.
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