scholarly journals Racial Disparities in Triple Negative Breast Cancer: A Review of the Role of Biologic and Non-biologic Factors

2020 ◽  
Vol 8 ◽  
Author(s):  
Om Prakash ◽  
Fokhrul Hossain ◽  
Denise Danos ◽  
Adam Lassak ◽  
Richard Scribner ◽  
...  
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Risk Factors ◽  
Racial Disparities ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
The United States ◽  
Poor Survival ◽  
Potential Interactions ◽  
Biologic Factors

Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer that lacks expression of the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor (HER2). TNBC constitutes about 15–30 percent of all diagnosed invasive breast cancer cases in the United States. African-American (AA) women have high prevalence of TNBC with worse clinical outcomes than European-American (EA) women. The contributing factors underlying racial disparities have been divided into two major categories based on whether they are related to lifestyle (non-biologic) or unrelated to lifestyle (biologic). Our objective in the present review article was to understand the potential interactions by which these risk factors intersect to drive the initiation and development of the disparities resulting in the aggressive TNBC subtypes in AA women more likely than in EA women. To reach our goal, we conducted literature searches using MEDLINE/PubMed to identify relevant articles published from 2005 to 2019 addressing breast cancer disparities primarily among AA and EA women in the United States. We found that disparities in TNBC may be attributed to racial differences in biological factors, such as tumor heterogeneity, population genetics, somatic genomic mutations, and increased expression of genes in AA breast tumors which have direct link to breast cancer. In addition, a large number of non-biologic factors, including socioeconomic deprivation adversities associated with poverty, social stress, unsafe neighborhoods, lack of healthcare access and pattern of reproductive factors, can promote comorbid diseases such as obesity and diabetes which may adversely contribute to the aggression of TNBC biology in AA women. Further, the biological risk factors directly linked to TNBC in AA women may potentially interact with non-biologic factors to promote a higher prevalence of TNBC, more aggressive biology, and poor survival. The relative contributions of the biologic and non-biologic factors and their potential interactions is essential to our understanding of disproportionately high burden and poor survival rates of AA women with TNBC.

scholarly journals Panoptic Overview of Triple-Negative Breast Cancer in Nigeria: Current Challenges and Promising Global Initiatives

2018 ◽  
pp. 1-20
Author(s):  
Nikita Wright ◽  
Padmashree Rida ◽  
Emad Rakha ◽  
Ayodeji Agboola ◽  
Ritu Aneja
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Resource Constraints ◽  
African Ancestry ◽  
Expression Patterns ◽  
Tumor Biology ◽  
The United States ◽  
Nigerian Women

PurposeTriple-negative breast cancer (TNBC) is the most deadly form of breast cancer (BC) today. TNBC treatment is fraught with challenges because of the extensive interpatient heterogeneity in clinical behavior and scarcity of stratifying biomarkers and actionable targets. Women of African ancestry face a disproportionate burden resulting from this disease, which affects them earlier and more aggressively and has a higher propensity to spread and resist conventional treatments. A much higher proportion of Nigerian patients with BC have TNBC compared with patients with BC in the United States and Europe.MethodsThis article spotlights Nigeria as an example of a nation wherein genetic and nongenetic spheres of influence intersect to affect the prevalence of this disease, the scale of its challenge, and its toll.ResultsStudies have illuminated the inherently different tumor biology of Nigerian TNBCs, which show distinct genetic variants and gene expression patterns compared with European or European-American TNBCs. Parallels are apparent between TNBC phenotypes among African Americans and Nigerians, implicating the common thread of shared genetic ancestry between these populations. Reproductive, lifestyle, socioeconomic, and cultural factors also shape TNBC outcomes in Nigeria, as do resource constraints in Nigerian health care and research sectors.ConclusionIncreasing our understanding of how these factors contribute to poorer outcomes among Nigerian women may uncover valuable insights and strategies in alleviating the TNBC burden in many countries of the world and help reduce the racial disparity in BC-related outcomes here in the United States. Importantly, this review also highlights collaborative global and local initiatives that converge expertise and resources to advance research on effective management of TNBC in diverse populations.

scholarly journals Racial Disparities in Triple Negative Breast Cancer: Toward a Causal Architecture Approach

2021 ◽  
Author(s):  
Scott D. Siegel ◽  
Madeline M. Brooks ◽  
Shannon M. Lynch ◽  
Jennifer Sims-Mourtada ◽  
Zachary T. Schug ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Alcohol Use ◽  
Racial Disparities ◽  
Triple Negative Breast Cancer ◽  
Invasive Breast Cancer ◽  
Neighborhood Effects ◽  
Triple Negative ◽  
Unhealthy Alcohol Use ◽  
Unhealthy Alcohol

Abstract Background: Triple negative breast cancer (TNBC) is an aggressive subtype of invasive breast cancer that disproportionately affects Black women and contributes to racial disparities in breast cancer mortality. Prior research has suggested that neighborhood effects may contribute to this disparity beyond individual risk factors.Methods: The sample included a cohort of 3,316 breast cancer cases diagnosed between 2012 and 2020 in New Castle County, Delaware, a geographic region of the US with elevated rates of TNBC. Multilevel methods and geospatial mapping evaluated whether the race, income, and race/income versions of the neighborhood Index of Concentration at the Extremes (ICE) metric could efficiently identify census tracts (CT) with higher odds of TNBC relative to other forms of invasive breast cancer. Odds ratios (OR) and 95% confidence intervals (CI) were reported; p-values <0.05 were significant. Additional analyses examined area-level differences in exposure to metabolic risk factors, including unhealthy alcohol use and obesity.Results: The ICE-Race, -Income-, and Race/Income metrics were each associated with greater census tract odds of TNBC on a bivariate basis. However, only ICE-Race was significantly associated with higher odds of TNBC after adjustment for patient-level age and race (most disadvantaged CT: OR= 2.09; 95%CI=1.40-3.13), providing support for neighborhood effects. Higher counts of alcohol and fast-food retailers, and correspondingly higher rates of unhealthy alcohol use and obesity, were observed in CTs that were classified into the most disadvantaged ICE-Race quintile and had the highest odds of TNBC. Conclusion: The use of ICE can facilitate the monitoring of cancer inequities and advance the study of racial disparities in breast cancer.

scholarly journals Clinical and economic burden associated with stage III to IV triple-negative breast cancer: A SEER-Medicare historical cohort study in elderly women in the United States

Cancer ◽  
2018 ◽  
Vol 124 (10) ◽  
pp. 2104-2114 ◽  
Author(s):  
Kendra L. Schwartz ◽  
Michael S. Simon ◽  
Lauren C. Bylsma ◽  
Julie J. Ruterbusch ◽  
Jennifer L. Beebe-Dimmer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Cohort Study ◽  
Triple Negative Breast Cancer ◽  
Economic Burden ◽  
Triple Negative ◽  
Elderly Women ◽  
The United States ◽  
Stage Iii ◽  
Historical Cohort
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