Herein, we report the characterization of four cohorts of breast cancer patients including (1) non-Hispanic Whites in Florida, (2) non-Hispanic Blacks in Florida, (3) Hispanics in Florida, and (4) Hispanics in Puerto Rico. Data from female breast cancer patients were collected from cancer registry (n = 9361) and self-reported patient questionnaires (n = 4324). Several statistical tests were applied to identify significant group differences. Breast cancer patients from Puerto Rico were least frequently employed and had the lowest rates of college education among the groups. They also reported more live births and less breastfeeding. Both Hispanic groups reported a higher fraction experiencing menstruation at age 11 or younger (Floridian Hispanics [38

Abstract Introduction: In the US, 1 in 8 women face a breast cancer diagnosis within their lifetime. While this disease is pervasive, it does not affect all groups of women equally. Non-Hispanic Black (NHB) populations tend to have worse survival outcomes than Non-Hispanic White (NHW) and Hispanic (H) populations. Studying this disparity presents challenges, as it is influenced by many social and biological factors, including quality of cancer care. By comparing NHB, NHW, and H breast cancer patients at Moffitt Cancer Center (MCC), we can describe various factors related to disparate outcomes, while attenuating the effect of varying cancer care settings. Methods: Clinical data (collected from 1986-2018) and patient questionnaire data (collected from 2012-2020) were acquired from MCC databases. Patients were divided into NHW, NHB, and H groups based on their race and ethnicity. Family cancer history, hormonal contraception use, and HR/HER2 subtype were selected for analysis due to their relevance to breast cancer risk or prognosis. Descriptive statistics, chi-square tests, ANOVA, and Tukey tests were performed as appropriate. Results: On preliminary analysis, NHW patients most frequently report a history of cancer diagnosis in one or more first-degree relatives. This is found when considering all cancer types (p<0.001) as well as specifically considering breast, ovarian, and uterine cancer (p=0.029). Patients also disclosed their hormonal contraception use, with 38% of NHW patients reporting an age at which they began using hormonal contraception compared to only 22% of both NHB and H patients (p<0.001). Among those who have used hormonal contraception, there was no significant difference in age of use onset, or total years of use. Significant differences in HR+/HER2-(p<0.001) and HR-/HER2- (p<0.001) frequency were seen between groups. NHB women had the lowest frequency of HR+/HER2- cancers (57%), and the highest frequency of HR-/HER2- cancers (27%). HR-/HER2+ NHB patients displayed significantly worse overall survival relative to NHW (p<0.001) and H (p=0.014) patients of the same subtype. HR+/HER2-NHB patients also have significantly worse overall survival relative to NHW (p=0.010) and H (p=0.010) patients of the same subtype. No significant difference in between-group overall survival is found for the HR-/HER2- and HR+/HER2+ patients. Conclusion: The cohorts in this study provide an opportunity to analyze characteristics and outcomes in breast cancer patients at an NCI-Designated Comprehensive Cancer Center. Higher rates of family cancer history in NHW women and higher rates of HR-/HER2- disease in NHB women align with the literature. NHW patients more frequently reported hormonal contraception use, while showing similarities to NHB and H groups in age and length of use. Despite comparable survival in two HR/HER2 subtypes, HR-/HER2+ and HR+/HER2- NHB women have significantly worse survival than NHW and H women. Further analyses of risk/prognostic factors and treatment regimens are needed to better understand this concerning survival finding. Citation Format: Abigail E. Lantz, Jiannong Li, Ryan F. Gebert, Dung-Tsa Chen, Edna R. Gordián, W. Douglas Cress. Poor survival in non-Hispanic Black HR+/HER2- and HR-/HER2+ breast cancer patients at an NCI-Designated Comprehensive Cancer Center [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C144.

Introduction: There are known disparities in outcome among breast cancer patients from different ancestral backgrounds that may relate to differences in socio-cultural factors and biological factors, such as hormone receptor expression. The Puerto Rico Biobank (PRBB) of the NCI-funded Ponce Health Sciences University (PHSU) - Moffitt Cancer Center (MCC) Partnership to Advance Cancer Health Equity serves as a resource for cancer research in underrepresented Latinx populations. To better serve breast cancer researchers, the PRBB has constructed a multi-ethnic breast cancer tissue microarray (ME-BrTMA) that represents patients from four different racial and ethnic groups; 1) non-Hispanic whites (NHW), 2) non-Hispanic Blacks (NHB), 3) Hispanics treated in Florida (HF) and 4) Hispanics from Puerto Rico (HPR), as well as control tissues. Procedures: Clinical data associated with female breast cancer patients was collected from the MCC and PRBB databases. The MCC patients were further separated into three groups based on race and ethnicity: NHW, NHB, and HF. Patients who did not have a definitive positive or negative result for estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) were excluded. Hormone receptor (HR) status was considered positive if ER and/or PR were positive and was considered negative if both ER and PR were negative. Descriptive statistics on the molecular subtypes were performed. Results: Preliminary analysis demonstrates that the rates of the HR+/HER2- subtype were highest among the NHW group at 73%, followed by 71% of HPRs, 69% of HFs, and 57% of NHBs. The rate of HR-/HER2- (triple negative) breast cancer was highest among the NHB group at 27%, followed by 14% of HFs, 12% of NHWs, and 10% of HPRs. While the rates of HR+/HER2+ cancers in all 3 MCC groups were within 10-11%, the rate of this subtype in HPRs was 19%. Conversely, HR-/HER2+ cancers made up 5-6% of each of the three MCC groups and 0% of the HPR group. The ME-BrTMA contains breast tissue from a subset of the four groups for which we have hormone receptor status, representing a total of 174 patients (most contributing two tumor cores, one normal core, and one stroma core) with each of the groups adequately represented. Conclusions: The proportions of breast cancer subtypes among the MCC patient populations supported established trends. The data affirmed the concerningly high rate of triple negative breast cancer among NHB populations in the United States. The wide variety of tissue samples within the ME-BrTMA make it a useful tool for future investigations. Additional chart review, RNA sequencing, and ancestry analysis using GWAS are being performed on tissues included in the ME-BrTMA, to provide additional data resources. Citation Format: Abigail E. Lantz, Allison Bahr, Edna R. Gordián, Jaileene Pérez-Morales, Marilin Rosa, Jamie K. Teer, Dung-Tsa Chen, José A. Oliveras, Julie Dutil, Teresita Muñoz-Antonia, Idhaliz Flores, W. Douglas Cress. The Puerto Rico BioBank (PRBB) multi-ethnic breast cancer tissue microarray (ME-BrTMA): A powerful tool for cancer research in underrepresented minorities [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A068.

Abstract The breast cancer mortality rate in Puerto Rican women is higher when compared to Hispanic women in the United States, despite having similar incidence. While disparities are well documented between Non-Hispanic Blacks and Non-Hispanic Whites, Hispanic populations have not been explored as thoroughly. Previous studies have identified high Body Mass Index (BMI) as a risk factor in postmenopausal breast cancer. Breast cancer incidence tends to increase with age, but younger age of diagnosis may be related to more aggressive disease. Studies have demonstrated that mammogram and continuous breast cancer screening can reduce mortality through early detection. Our study focuses on characterizing BMI, age at diagnosis, and screening information in Puerto Rican women obtained from a patient survey administered by the Puerto Rico BioBank (PRBB). These factors may contribute to the observed disparity in breast cancer mortality in these patients. Data abstracted from the PRBB self-reported questionnaire identified 260 females who had been diagnosed with breast cancer between the ages of 25 and 86. The questionnaire includes demographic, family history, lifestyle, and cancer-related questions. BMI was calculated from the self-reported height and weight values, then classified according to the Center for Disease Control (CDC) categories: underweight (<18.5), healthy (18.5-24.9), overweight (25.0-29.9), and obese (≥30.0). Age at diagnosis and frequency of patients who reported getting annual mammograms were both recorded. Descriptive statistics were performed. According to the CDC categories of BMI, 106 respondents (41.2%) were obese, 88 (34.2%) were overweight, 58 (22.6%) were of a healthy weight, and 5 (1.9%) were underweight. This indicates that approximately 77% of the respondents had a BMI outside of the healthy range. The average BMI of 28.8 and median BMI of 28.4 both fall within the overweight category, and the population standard deviation was 5.9. The mean age at diagnosis among our cohort was 56.78 years. The percentage of women who reported having a mammogram annually was 81%. Our data suggests that Puerto Rican women have a high rate of screening using mammograms and have a high BMI. This study suggests that the distribution in age in Puerto Rican women are in-line with national averages. Further examination of breast cancer among Puerto Rican women is needed to establish consistent risk factors and mitigate any health disparities confirmed among this population of breast cancer patients. Citation Format: Abigail E. Lantz, William D. Cress, Allison Bahr, Edna Gordián, Jaileene Perez-Morales, Idhaliz Flores, María Rojas. Body mass index, age at diagnosis, and mammography screening behaviors in women diagnosed with breast cancer in Puerto Rico [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-218.