Race and triple negative threats to breast cancer survival: a population-based study in Atlanta, GA

摘要: Background Breast cancers with a triple negative tumor (TNT) subtype (as defined by lacking protein expression of estrogen receptor (ER), progesterone (PR), and human epidermal growth factor 2 (HER2)) preclude the use available targeted therapies may contribute to poor outcome historically poorest survival observed among African–American (AA) women. This study examines association ER/PR/HER2 subtypes race breast cancer survival. Methods tumors from population-based cohort 116 AA 360 white Atlanta women aged 20–54, diagnosed 1990 1992 were centrally reviewed tested immunohistochemistry. Multivariate analyses within (TNT, ER−PR−HER2+, ER+/PR+HER2+, ER+/PR+HER2−) conducted using weighted Cox regression included socio-demographic, prognostic, treatment factors. Results TNTs more prevalent young particularly (Odds Ratio [OR] = 1.9, 95% Confidence Interval [CI] 1.2–2.9), adjusting for age, stage, grade, poverty index. Overall mortality was higher (Hazard [HR] = 1.9, CI, 1.5–2.5) differed (P < 0.001). Within TNT subtype, racial differences in persisted, after additional adjustment comorbidities (HR = 2.0, CI 1.0–3.7). uniquely associated high p16, p53, Cyclin E; low Bcl-2 D1 expression. Conclusions The prevalence younger women, along unique patterns poorer survival, suggests varying gene–environment etiologies respect age race/ethnicity need effective therapies.