Distinctions in Breast Tumor Recurrence Patterns Post-Therapy among Racially Distinct Populations

• Type of Material: Article
• Authors: Nikita Wright, Georgia State University; Jun Xia, Georgia State University; Guilherme Cantuaria, Northside Hospital Cancer Institute; Sergey Klimov, Georgia State University; Mildred Jones, Northside Hospital Cancer Institute; Pranay Neema, Georgia State University; Dora Il'yasova, Georgia State University; Uma Krishnamurti, Emory University; Xiaoxian Li, Emory University; Michelle Reid, Emory University; Meenakshi Gupta, West Georgia Hospitals; Padmashree C. G. Rida, Georgia State University; Remus Osan, Georgia State University; Ritu Aneja, Georgia State University
• Language: English
• Date: 2017-01-13
• Publisher: Public Library of Science
• Publication Version: Final Published Version
• Copyright Statement: © 2017 Wright et al.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1371/journal.pone.0170095
• Title of Journal or Parent Work: PLoS ONE
• ISSN: 1932-6203
• Volume: 12
• Issue: 1
• Start Page: e0170095
• End Page: e0170095
• Grant/Funding Information: National Cancer Institute R01 CA169127 to Ritu Aneja.; National Cancer Institute U01 CA179671 to Ritu Aneja.
• Keywords: PROGNOSIS; Cancer treatment; STAGE; Cancer chemotherapy; LIFE; Cancer detection and diagnosis; Breast cancer; Hormonal therapy; CANCER; YOUNG-WOMEN; DISPARITIES; AGE; AFRICAN-AMERICAN WOMEN; Science & Technology; Radiation therapy; Breast tumors; Death rates; Multidisciplinary Sciences; WHITE WOMEN; SURVIVAL; Science & Technology - Other Topics
• Research Categories: Health Sciences, Oncology

Abstract

Background: Clinical studies have revealed a higher risk of breast tumor recurrence in African-American (AA) patients compared to European-American (EA) patients, contributing to the alarming inequality in clinical outcomes among the ethnic groups. However, distinctions in recurrence patterns upon receiving hormone, radiation, and/or chemotherapy between the races remain poorly characterized. Methods: We compared patterns and rates (per 1000 cancer patients per 1 year) of recurrence following each form of treatment between AA (n = 1850) and EA breast cancer patients (n = 7931) from a cohort of patients (n = 10504) treated between 2005-2015 at Northside Hospital in Atlanta, GA. Results: Among patients who received any combination of adjuvant therapy, AA displayed higher overall rates of recurrence than EA (p = 0.015; HR: 1.699; CI: 1.108-2.606). Furthermore, recurrence rates were higher in AA than EA among stage I (p = 0.031; HR: 1.736; CI: 1.052-2.864) and T1 classified patients (p = 0.003; HR: 2.009; CI: 1.263-3.197). Interestingly, among patients who received neoadjuvant chemotherapy, AA displayed higher rates of local recurrence than EA (p = 0.024; HR: 7.134; CI: 1.295-39.313). Conclusion: Our analysis revealed higher incidence rates of recurrence in AA compared to EA among patients that received any combination of adjuvant therapy. Moreover, our data demonstrates an increased risk of tumor recurrence in AA than EA among patients diagnosed with minimally invasive disease. This is the first clinical study to suggest that neoadjuvant chemotherapy improves breast cancer recurrence rates and patterns in AA.