Treatment and Survival Outcome for Molecular Breast Cancer Subtypes in Black Women

ABSTRACT Background The randomized placebo-controlled Vitamin D and Omega-3 Trial suggested a possible benefit of vitamin D on cancer incidence among black individuals. However, data are limited regarding the impact of vitamin D on breast cancer subtypes among African-American/black women, who tend to develop more aggressive forms of breast cancer. Objectives We hypothesize that more vitamin D exposure (through diet, supplements, and sunlight) and higher intake of calcium are associated with decreased risk of estrogen receptor (ER)+ and ER− breast cancer, and of triple-negative breast cancer (TNBC) among black women. Methods This study was conducted among 1724 black cases and 1233 controls in the Women's Circle of Health Study (WCHS) and WCHS2. Polytomous logistic regressions were used to estimate ORs and 95% CIs of ER+ and ER− breast cancer; logistic regressions were used for TNBC. The ORs from each study were pooled using an inverse-variance-weighted random-effects model. Results Dietary vitamin D and calcium intake were not associated with risk of breast cancer subtypes in the pooled analysis. For supplemental vitamin D, we observed possible inverse associations between intake of ≤800 IU/d (compared with nonuse) and risk of several subtypes, with effects that appeared strongest for TNBC (OR: 0.58; 95% CI: 0.35, 0.94); no association was found for >800 IU/d. More daylight hours spent outdoors in a year was associated with lower risk of ER+, ER−, and TNBC (e.g., highest compared with lowest quartile: TNBC OR: 0.53; 95% CI: 0.31, 0.91; P-trend = 0.02). Conclusions Moderate supplemental vitamin D intake was associated with decreased risk of TNBC, and increased sun exposure was associated with reduced risk of ER+, ER−, and TNBC among black women.

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Risk factors for breast cancer subtypes among Black women undergoing screening mammography

Breast Cancer Research and Treatment ◽

10.1007/s10549-021-06340-2 ◽

2021 ◽

Author(s):

Tara M. Friebel-Klingner ◽

Sarah Ehsan ◽

Emily F. Conant ◽

Despina Kontos ◽

Susan M. Domchek ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Black Women ◽

Screening Mammography ◽

Breast Cancer Subtypes ◽

Cancer Subtypes

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Neighborhood social environmental factors and breast cancer subtypes among Black women

Cancer Epidemiology Biomarkers & Prevention ◽

10.1158/1055-9965.epi-20-1055 ◽

2020 ◽

pp. cebp.1055.2020

Author(s):

Bo Qin ◽

Riddhi A. Babel ◽

Jesse J. Plascak ◽

Yong Lin ◽

Antoinette M Stroup ◽

...

Keyword(s):

Breast Cancer ◽

Black Women ◽

Environmental Factors ◽

Breast Cancer Subtypes ◽

Cancer Subtypes ◽

Social Environmental ◽

Social Environmental Factors

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Breast cancer subtypes among Eastern‐African–born black women and other black women in the United States

Cancer ◽

10.1002/cncr.32293 ◽

2019 ◽

Vol 125 (19) ◽

pp. 3401-3411 ◽

Cited By ~ 5

Author(s):

Hyuna Sung ◽

Carol E. DeSantis ◽

Stacey A. Fedewa ◽

Eva J. Kantelhardt ◽

Ahmedin Jemal

Keyword(s):

Breast Cancer ◽

United States ◽

Black Women ◽

The United States ◽

Breast Cancer Subtypes ◽

Cancer Subtypes

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Population-Based Study on Cancer Subtypes, Guideline-Concordant Adjuvant Therapy, and Survival Among Women With Stage I–III Breast Cancer

Journal of the National Comprehensive Cancer Network ◽

10.6004/jnccn.2018.7272 ◽

2019 ◽

Vol 17 (6) ◽

pp. 676-686 ◽

Cited By ~ 2

Author(s):

Mei-Chin Hsieh ◽

Lu Zhang ◽

Xiao-Cheng Wu ◽

Mary B. Davidson ◽

Michelle Loch ◽

...

Keyword(s):

Breast Cancer ◽

Adjuvant Therapy ◽

Breast Cancer Subtype ◽

Population Based ◽

Survival Outcome ◽

Stage I ◽

Breast Cancer Subtypes ◽

Population Based Study ◽

Cancer Subtypes ◽

Cancer Subtype

Background: Breast cancer subtype is a key determinant in treatment decision-making, and also effects survival outcome. In this population-based study, in-depth analyses were performed to examine the impact that breast cancer subtype and receipt of guideline-concordant adjuvant systemic therapy (AST) have on survival using a population-based cancer registry’s data. Methods: Women aged ≥20 years with microscopically confirmed stage I–III breast cancer diagnosed in 2011 were identified from the Louisiana Tumor Registry. Breast cancer subtypes were categorized based on hormone receptor (HR) and HER2 status. Guideline-concordant treatment was defined using the NCCN Guidelines for Breast Cancer. Logistic regression was applied to identify factors associated with guideline-concordant AST receipt. Kaplan-Meier survival curves were generated to compare survival among subtypes by AST receipt status, and a semiparametric additive hazard model was used to verify the factors impacting survival outcome. Results: Of 2,214 eligible patients, most (70.8%) were HR+/HER2– followed by HR–/HER2– (14.4%), and 78.6% received guideline-concordant AST. Compared with patients with the HR+/HER2+ subtype, women with other subtypes were more likely to be guideline-concordant after adjusting for sociodemographic and clinical variables. Women with the HR–/HER2+ or HR–/HER2– subtype had a higher risk of any-cause and breast cancer–specific death than those with the HR+/HER2+ subtype. Those who did not receive AST had an additional adjusted hazard of 0.0191 (P=.0001) in overall survival and 0.0126 (P=.0011) in cause-specific survival compared with those who received AST. Conclusions: Most patients received guideline-concordant AST, except for those with the HR+/HER2+ subtype. Patients receiving guideline-adherent adjuvant therapy had better survival outcomes across all breast cancer subtypes.

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Abstract PO-151: Risk factors associated with breast cancer subtypes among Black women that have undergone screening mammography

10.1158/1538-7755.disp20-po-151 ◽

2020 ◽

Author(s):

Tara Friebel ◽

Sarah Ehsan ◽

Susan Domchek ◽

Despina Kontos ◽

Emily Constant ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Black Women ◽

Screening Mammography ◽

Breast Cancer Subtypes ◽

Cancer Subtypes ◽

Factors Associated

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Abstract C063: Impact of neighborhood socioeconomic status on breast cancer subtypes among Black women

10.1158/1538-7755.disp19-c063 ◽

2020 ◽

Author(s):

Bo Qin ◽

Adana A.M. Llanos ◽

Riddhi Babel ◽

Jesse J. Plascak ◽

Karen Pawlish ◽

...

Keyword(s):

Breast Cancer ◽

Socioeconomic Status ◽

Black Women ◽

Breast Cancer Subtypes ◽

Cancer Subtypes ◽

Neighborhood Socioeconomic Status

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Expression of vascular endothelial growth factor (VEGF), p53 in Molecular breast cancer subtypes of pre-menopausal African-American women

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.21084 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 21084-21084

Author(s):

C. U. Ihemelandu ◽

L. D. Leffall ◽

T. J. Naab ◽

W. A. Frederick

Keyword(s):

Breast Cancer ◽

African American Women ◽

Molecular Subtypes ◽

P53 Protein ◽

Survival Outcome ◽

Breast Cancer Subtypes ◽

Luminal A ◽

Cancer Subtypes ◽

Luminal B ◽

Her 2

21084 Background: Tumor growth and metastasis have been shown to be dependent on angiogenesis. With the current classification of breast tumors into molecular subtypes with distinct prognosis and response to treatment, we sort to analyze the expression of the angiogenesis markers in molecular subtypes and determine their association with clinicopathologic variables of prognostic significance. Methods: A retrospective analysis of women diagnosed with breast cancer from 1998–2005, who had assessable data for ER, PR, and Her-2/neu status. The molecular subtypes were defined as: luminal A, luminal B, basal-like , and Her-2/neu. Results: All molecular breast cancer subtypes overexpressed VEGF, with no statistically significant difference noted between the subtypes: - luminal A (69.8%) basal-like (71.1%), luminal B (70.0%), Her-2/neu (71.0%) (p=.99). Subtypes differed significantly in expression of p53 (p<.000), with the basal-like and Her-2/neu subtypes more likely to be associated with p53 mutations (51.7%) and (54.1%) respectively. No statistically significant association between p53 protein and increased VEGF expression was noted (p=.176) Statistically significant associations between p53 protein and prognostic factors ER (p<.000), PR (p>.000), histologic grade (p<.000), S-phase fraction (p<.001) were noted. A significant inverse correlation was noted between p53 expression and thrombospodin for the age-group <35 years (rho -.810; p=.003). VEGF showed no significant association with the prognostic factors ER, PR, histologic grade and S-phase fraction. A tendency not reaching statistical significance was found between VEGF and angiogenesis (p=.09). A direct correlation between VEGF and thrombospodin was noted in the age- group < 35 years (rho .800; p=.01). Expression of VEGF and thrombospodin did not correlate with survival outcome; however angiogenesis seemed to correlate with survival outcome. Survival outcome was influenced by molecular subtypes with the basal-like and Her-2/neu subtypes having a poorer outcome (p=.01). Conclusions: VEGF expression is not related to p53 status or survival outcome in molecular breast cancer subtypes of pre-menopausal African-American women. No significant financial relationships to disclose.

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