Racial-specific differences in breast cancer treatment

Although the incidence of breast cancer (BCa) among Blacks is lower than Whites, health outcomes are dire, as the cancer is often diagnosed at a higher grade and more advanced stage. Additionally, in Blacks, BCa tends to be more aggressive, as triple negative breast cancer is more prevalent, is more lethal and less treatable than the cognate disease in Whites. In addition to the high prevalence of aggressive disease in Blacks, we hypothesized that recurrence and survival outcomes may also be due to treatment differences between populations. Therefore, the objective of this study was to determine if there were racial-specific treatment differences in BCa cases in Washington, DC (N=5932) between 2000 and 2010. Using chi-square and regression analysis, we demonstrate that after controlling for age, stage, grade, ER, PR, HER2, and BCa molecular subtype, no significant racial-specific differences in surgery or radiation were found. However, overall, Blacks and Hispanics were more likely to receive chemotherapy for BCa when compared to whites (OR for Blacks: 3.57, 95% CI: 1.66-8.33 and OR for Hispanics: 4.76, 95% CI: 1.33-0.16.67). Among those with Stage 3 and 4 BCa, Blacks and Hispanics were still more likely to receive chemotherapy (OR for Blacks: 1.93, 95% CI: 1.16-3.20 and OR for Hispanics: 3.95, 95% CI: 1.03-15.15). Differences in hormonal therapy were also found with Blacks and Hispanics being more likely to receive hormone therapy for ER and/or PR positive disease (OR for Blacks: 3.12, 95% CI: 1.27-7.69 and OR for Hispanics: 8.33, 95% CI: 2.27-33.33). Studies that identify driving factors behind these racial-related treatment differences are warranted. Citation Format: Brittany N. Barley, Sara Horton, Jacqueline Dunmore-Griffith, Luisel Ricks-Santi. Racial-specific differences in breast cancer treatment. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr C48. doi:10.1158/1538-7755.DISP13-C48