Cancer-Specific Mortality Is Higher Among Younger Black Female Patients With Breast Cancer

The risk of cancer-specific mortality in breast cancer was increased for younger adult Black female patients compared with younger adult White female patients, according to results from a retrospective study presented during the NCCN 2022 Annual Conference.¹

At a median follow-up of 33 months (interquartile range, 15-55), the hazard ratio (HR) for cancer-specific mortality was 1.21 in Black women vs White women (95% CI, 1.06-1.37; P = .004). The mean cancer-specific survival for White patients with breast cancer was 76.15 months (95% CI, 75.84-77.02) months compared with 72.15 months (95%, CI 71.20-73.11) months for Black patients.

“We found that Black women had a 21% increased risk in breast cancer–specific mortality compared [with] White women,” said lead study author Malak Abuamsha, MD, MPH, of Baldwin Wallace University.²

Already the most common cancer among young women, breast cancer cases have been rising over the past decade. Younger patients typically present with more aggressive disease at diagnosis, leading to a less favorable prognosis. Although racial disparities regarding the incidence rates and outcomes in cancer have been well documented, little research has been conducted on the effect of racial disparities in younger women.

The retrospective study examined female patients aged 40 years and younger who were diagnosed with primary breast cancer between 2010 and 2016 by utilizing data from the United States Surveillance, Epidemiology, and End Results Database. The association between mortality and other patient characteristics was examined with the cox proportional hazard regression analysis. Cancer-specific survival rates across racial groups were estimated with the Kaplan-Meier method.

The retrospective cohort featured 21,646 female patients. Specifically, 71.27% of patients were White (n = 15,428), 15.31% were Black (n = 3,314), 12.67% were Asian or Pacific Islander (n = 2,742), and 0.75% were American Indian/Alaskan Native (n = 162). The mean age of all patients at diagnosis was 36 years (± 4 standard deviation years).

Women examined in the retrospective study had triple-negative breast cancer (TNBC); HER2-positive, hormone receptor–negative disease; hormone receptor–positive, HER2-negative disease; and hormone receptor­–positive, HER2-positive disease, ranging from stage I to stage IV. Patients were included in the study irrespective of prior surgery, radiation, or chemotherapy.

Additional data found that across all racial groups, TNBC was associated with a higher risk of cancer-specific mortality (HR, 3.57; 95% CI, 3.02-4.22; P < .001). Patients who were at a higher stage of disease at the time of diagnosis, uninsured, or had a low socioeconomic status also had a higher risk of breast cancer-specific mortality, regardless of racial group.

“Our findings suggested that the racial disparity in breast cancer survival exists among young women. We recommend further studies to examine the factors that influence these disparities in order to improve outcomes,” Abuamsha concluded.

References

1. Abuamsha M, Abuamsha H, Bahelah R. Racial disparities in breast cancer-specific survival among women aged 40 years or younger in the United States. J Natl Compr Canc Netw. 2022; 20(3.5). doi:10.6004/jnccn.2021.7210
2. Abuamsha M. Malak Abuamsha shares their research. YouTube. March 7, 2022. Accessed April 26, 2022. https://www.youtube.com/watch?v=U5bzO-4bBRU