Race Differences in Breast Cancer Survival
Annual rept. 1 Jul 1999-30 Jun 2000
YALE UNIV NEW HAVEN CT
Pagination or Media Count:
This is a population based follow-up study of 145 African American AA and 177 white W women who were diagnosed with breast cancer between 1987 and 1989. As of January, 1999, 135 41.9 of the women had died with an average time to death of 4.7 years. Survival among AA women 56.9 was significantly lower than survival in W women 68.9 AGE-ADJUSTED Risk Ratio RR 1.73 95 Confidence Interval CI 1.21 - 2.48. The significant survival disadvantage persisted even with additional adjustment for TNM stage at diagnosis and one measure of socioeconomic status education RR 1.49, 95 CI 1.02 - 2.19. Several tumor characteristics differed by race group, with African American women more likely to be in the higher risk category. African American women were twice as likely to be diagnosed with tumors that were TNM stage II or higher age-adjusted Odds Ratio OR 2.01, 95 Confidence Interval CI 1.24 - 3.24. Evaluating archived tissue specimens, we have demonstrated race differences in a number of other tumor characteristics and genetic alterations AA women were significantly more likely than W women to have tumors that were higher histologic grade higher nuclear, estrogen receptor negative, and p53 positive, all of which are associated with relatively poor prognosis. Although AA women were more likely than W women to be progesterone receptor negative 61 vs. 50, and to express c-met 62 vs. 56, these differences were not statistically significant. AA women were not significantly more likely to be HER-2 NEU positive. African American women were more likely not significant to be positive for a number of known prognostic indicators necrosis, lymphatic invasion, skin or nipple involvement. In summary, tumors in African American women were more likely to be to have characteristics associated with poor prognosis than were white women, explanatory variable.
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