Despite a slightly lower breast cancer incidence rate compared with white women, Black women diagnosed with breast cancer have a poorer prognosis, regardless of disease subtype, according to a study presented at the recent virtual American Society of Clinical Oncology annual meeting.
In this exclusive MedPage Today video, study author Julia Blanter, MD, of the Icahn School of Medicine at Mount Sinai in New York City, discusses her abstract.
Following is a transcript of her remarks:
Our objective was to examine if differences exist in the risk of developing distant metastases after initial breast cancer diagnosis among Black versus white women. Our project began as a follow-up from a previous NIH-funded cross-sectional study from 2013 to 2020 designed to examine if insulin resistance mediated the association between race and breast cancer prognosis in self-identified Black and white women with a new diagnosis of breast cancer.
We decided to look at this topic namely from the background research we were doing. We found that Black women diagnosed with breast cancer are more likely to have a poor prognosis regardless of breast cancer subtype. And despite having a lower incidence rate of breast cancer when compared to white women, Black women have the highest breast cancer death rate of all racial and ethnic groups, a characteristic often attributed to late stage at diagnosis and that has been looked at over several decades.
This was a retrospective study. We looked at the electronic medical records of 441 patients at the Mount Sinai Health System to assess metastases not present at initial diagnosis. We then performed univariate and multivariate analysis to find if Black women had higher rates of distant metastases after diagnosis, and if these still exist, when accounting for factors such as age and stage.
What we found was that 6.9% of Black women had distant metastases after diagnosis, whereas only 1.2% of white women did. When performing multivariate analysis adjusting for age, race, and stage, Black women were still more likely to have distant metastases after diagnosis, which led us to conclude that the racial disparities do still exist in the development of distant metastases, and that this is independent from a late stage diagnosis.
This study opened the door for a lot of future projects, namely finding the source of the continued disparity. In our study, we did note that Black women had a shorter median follow-up time of 2.5 years, whereas white women had a median follow-up time of 3.1 years. These differences were statistically significant. However, we were unable to account for those who may have transitioned to care outside of the Mount Sinai Health System and may be being followed in a different institution.
I do think it would be beneficial to look at this more closely and see if there are true differences in follow-up time. Additionally, we did not stratify our cases based off of breast cancer subtype and treatment received, and we are hoping to do that in a future study to see if this still exists. Namely we found it concerning that the disparity does still exist despite many decades of research.
And we hope that as we continue to work on figuring out why these poor outcomes exist, we can start working on how to stop them.
Last Updated June 15, 2021
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