Breast Cancer in African American versus Caucasian Women: Difference in Gene Expression

e11582 Background: Breast cancer mortality has historically been higher in African American (AA) women compared to Caucasian women. Controlling for tumor characteristics, biological markers and comorbidities does not account for the disparity. Previous studies have shown that AA women are more likely to have a high 21-gene recurrence score compared to Caucasian women. Another potential variable affecting treatment outcomes is adherence to adjuvant endocrine therapy (ET). We conducted a retrospective review of pharmacy records at Grady Memorial Hospital (GMH) to examine the non-adherence rate among predominantly AA patients (pts). Methods: Pharmacy database records were examined for pts filling prescriptions for tamoxifen, anastrozole, or letrozole at GMH in Atlanta, Georgia from 2004-2009. Baseline characteristics were obtained by chart review. Pts were excluded if they had metastatic disease, DCIS, less than 60 days of eligible prescription, were male, deceased during the study period, benign disease, or no documentation of breast cancer in the electronic medical record (EMR). Non-adherence was defined as those filling less than 80% of eligible days covered by her prescription. Results: 679 pts were identified who filled prescriptions for tamoxifen, anastrozole, or letrozole at Grady pharmacy from 2004-2009. Pts who were excluded had metastatic disease (152), DCIS (101), had less than 60 days of eligible prescription (65), had no documentation of breast cancer in the EMR (25), were male (6), deceased before 2009 (5), or had benign disease (9). Of the 316 pts eligible for the study, median age was 60 (26 to 94) at time of diagnosis, 86% were AA, and 39% were node positive. 167 pts filled prescriptions for tamoxifen, 95 for anastrozole, and 54 for letrozole. The non-adherence rate for tamoxifen was 50%, anastrozole 38%, and letrozole 48%. Overall non-adherence rate was 46%. Conclusions: The overall non-adherence rate to adjuvant ET among a predominately AA population seen in a county hospital was similar to previously reported rates. Non-adherence to ET in this underserved AA pt population does not fully account for disparate outcomes.

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Mammography screening and detection of early stage breast cancer in Hispanic and African American women at a Minnesota safety net healthcare system.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e18074 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e18074-e18074

Author(s):

Daniel Fellows Pease ◽

David T. Gilbertson ◽

Andres Wiernik

Keyword(s):

Breast Cancer ◽

African American ◽

African American Women ◽

Healthcare System ◽

Early Stage ◽

Screening Mammography ◽

Advanced Stage ◽

American Women ◽

Younger Age ◽

Caucasian Women

e18074 Background: Approximately 12% of breast cancer cases occur in women younger than 50 years, per SEER data from 2012. Hispanic women are known to present at a younger age and African American women with more advanced stage disease. In this study, we describe the impact of age and race on the initial presentation of breast cancer among minority women treated at the Hennepin Healthcare System (HHS) in the state of Minnesota. Methods: A single-institution retrospective analysis of data from our electronic health record of all breast cancer diagnoses from 2010-2015. Cases were compared by age ( < 50 or > 50 years), race (Caucasian, African American, Hispanic, other), stage (AJCC 7th edition), and method of diagnosis (self-reported mass or screening mammography). Results: A total of 315 breast cancer diagnoses occurred at HHS from 2010-2015. In our cohort, 29% of all breast cancer cases were diagnosed in women < 50yrs. Hispanic and African American women had higher rates of diagnosis at < 50yrs compared to Caucasian women (38.9% vs 37.1% vs 18.1 respectively, p < 0.05). Early stage cancer (stage 0 or I) accounted for most diagnoses in those > 50yrs (54.8%), while advanced stage (stage II-IV) was more prevalent in the < 50yrs age group (59.5%) (p < 0.05). Of all women diagnosed with breast cancer, 63% presented with a self-reported mass and 37% were diagnosed by screening mammography. Hispanics and African American women had a higher rate of presentation with a self-reported mass (74% and 66% respectively) compared to Caucasian women (55%). Women with breast cancer < 50yrs were more likely to present with a self-reported mass than women > 50yrs (80% vs 55%, p < 0.05). 92% of Hispanic and 80% of African American women < 50yrs presented with a self-reported mass, compared to 62% of Caucasian women (p = 0.095). Conclusions: At our institution, Hispanic and African American women are diagnosed at a significantly younger age than Caucasian women, and those diagnosed at a younger age have more advanced disease. Presenting with a self-reported mass is very common for young non-Caucasian women. Whether screening mammography can be better utilized to change these trends requires further study.

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The mannose-binding lectin (MBL2) haplotype and breast cancer: an association study in African-American and Caucasian women

Carcinogenesis ◽

10.1093/carcin/bgl198 ◽

2006 ◽

Vol 28 (4) ◽

pp. 828-836 ◽

Cited By ~ 21

Author(s):

T. Bernig ◽

B. J. Boersma ◽

T. M. Howe ◽

R. Welch ◽

S. Yadavalli ◽

...

Keyword(s):

Breast Cancer ◽

African American ◽

Association Study ◽

Mannose Binding Lectin ◽

Mannose Binding ◽

Caucasian Women ◽

Binding Lectin

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Expression of Intratumoral IGF-II Is Regulated by the Gene Imprinting Status in Triple Negative Breast Cancer from Vietnamese Patients

International Journal of Endocrinology ◽

10.1155/2015/401851 ◽

2015 ◽

Vol 2015 ◽

pp. 1-13 ◽

Cited By ~ 1

Author(s):

Vinodh Kumar Radhakrishnan ◽

Lorraine Christine Hernandez ◽

Kendra Anderson ◽

Qianwei Tan ◽

Marino De León ◽

...

Keyword(s):

Breast Cancer ◽

Gene Expression ◽

African American Women ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

Gene Imprinting ◽

Vietnamese Women ◽

Tumor Tissues ◽

Incidence And Mortality ◽

Caucasian Women

African American women suffer higher incidence and mortality of triple negative breast cancer (TNBC) than Caucasian women. TNBC is very aggressive, causing the worst clinical outcome. We previously demonstrated that tumors from these patients express high IGF-II and exhibit high activation of the IGF signaling pathways. IGF-II gene expression is imprinted (monoallelic), promotes tumor progression, and metastasis and regulates Survivin, a TNBC prognostic marker. Since BC mortality has increased among young Vietnamese women, we analyzed 48 (paired) TNBC samples from Vietnamese patients to assess IGF-II expression. We analyzed all samples by qrtPCR for identification of IGF-II heterozygosity and to determine allelic expression of the IGF-II gene. We also analyzed the tissues for proIGF-II and Survivin by RT-PCR and Western blotting. A total of 28 samples displayed IGF-II heterozygosity of which 78% were biallelic. Tumors with biallelic IGF-II gene expression exhibited the highest levels of proIGF-II and Survivin. Although 100% of these tissues corresponding normal samples were biallelic, they expressed significantly lower levels of or no proIGF-II and Survivin. Thus, IGF-II biallelic gene expression is differentially regulated in normal versus tumor tissues. We propose that intratumoral proIGF-II is dependent on the IGF-II gene imprinting status and it will promote a more aggressive TNBC.

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