15 October 2015

A recent study has noted that African American and Hispanic women are more likely to be diagnosed with aggressive forms of breast cancer. Drs. Lu Chen and Christopher Lee published their findings, Racial Disparities in Breast Cancer Diagnosis and Treatment by Hormone Receptor and Her2 Status, in a recent issue of the journal Cancer Epidemiology, Biomarkers and Prevention.

Using information from SEER Registries, they identified 120,000 women, age 20 and over, diagnosed with invasive breast cancer between 2010-2011, with documented information about tumor stage, hormone receptor, and Her2 status. They evaluated the associations between patient race / ethnicity and stage at diagnosis as well as receipt of guideline-appropriate care. Findings included:

  • African American and Hispanic women were 30-60% more likely to be diagnosed with stage II-IV breast cancer compared with non-Hispanic white women
  • African American women had 40-70% risks of being diagnosed with stage IV breast cancer depending on tumor subtype
  • American Indian and Alaska Native women had a 3.9 times higher risk of stage IV triple-negative breast cancer
  • African American and Hispanic women were 30-40% more likely to receive non-guideline concordant care for their breast cancer

The findings reflect those reported earlier this year in the Journal of the National Cancer Institute. It is not news that African American and Hispanic women have worse breast cancer outcomes compared to other populations. They are more likely to be diagnosed at advanced stages, are less likely to receive guideline-appropriate treatment, and have worse overall survival. It is becoming clear that breast cancer is a different disease in women of different racial and ethnic backgrounds – they are more likely to have higher-risk subtypes. This study confirms these points, with the exception of survival, which was not assessed due to the short time period of data analysis (2010-2011). This emphasizes the need for continued research regarding the racial and ethnic variations in tumor subtypes.

Presentation at more advanced stage and lack of guideline-concordant care for African American and Hispanic women should be of concern to us all. This points to racial, ethnic and socioeconomic disparities in education, access to screening, and access to quality care. The authors concluded by stating:  “As contributors to racial / ethnic disparities in breast cancer are complex and multifactorial, continued efforts, especially targeted, culturally appropriate interventions, to address these disparities across different subtypes of breast cancer have the potential to reduce these long-standing disparities and hopefully close the existing survival gaps.”