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

• Published in: PloS one 2017-01, Vol.12 (1), p.e0170095-e0170095
• Main Authors: Wright, Nikita, Xia, Jun, Cantuaria, Guilherme, Klimov, Sergey, Jones, Mildred, Neema, Pranay, Il'yasova, Dora, Krishnamurti, Uma, Li, Xiaoxian, Reid, Michelle D, Gupta, Meenakshi, Rida, Padmashree C G, Osan, Remus, Aneja, Ritu
• Format: Article
• Language: English
• Subjects: Adult; African Americans; African Americans - statistics & numerical data; Age; Analysis; Biology; Breast cancer; Breast Neoplasms - ethnology; Breast Neoplasms - pathology; Breast Neoplasms - therapy; Cancer; Cancer recurrence; Cancer therapies; Care and treatment; Chemotherapy; Clinical outcomes; Combined Modality Therapy; Drug therapy; Epidemiology; Ethnicity; European Continental Ancestry Group - statistics & numerical data; Female; Follow-Up Studies; Health aspects; Hospitals; Humans; Laboratories; Lymphatic Metastasis; Lymphatic system; Mastectomy; Medical diagnosis; Medical prognosis; Medicine and Health Sciences; Metastasis; Middle Aged; Minority & ethnic groups; Mortality; Neoplasm Grading; Neoplasm Invasiveness; Neoplasm Recurrence, Local - ethnology; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - therapy; Neoplasm Staging; Pathology; Patients; People and Places; Population studies; Prognosis; Public health; Race; Radiation; Radiation therapy; Retrospective Studies; Statistics; Survival Rate; Womens health
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0170095

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. 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. 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). 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.