Primary tumor size, not race, determines outcomes in women with hormone-responsive breast cancer

Surgery. 2011 Oct;150(4):796-801. doi: 10.1016/j.surg.2011.07.066.

Abstract

Introduction: We sought to determine if there was a difference in outcomes in African-American compared with Caucasian women with hormone-responsive breast cancer, and whether this was related to race or other tumor and treatment variables.

Methods: We included 1,205 patients with hormone-responsive breast cancer were identified in the Kentucky Cancer Registry (1996-2007). The effect of race on survival was evaluated using Kaplan-Meier and Cox regression methodologies.

Results: In this cohort, 76.9% were Caucasian and 21.7% were African American. Compared with Caucasians, African-American women were older (57 vs 55 years; P = .032) and more likely to have larger tumors (19 vs 17 mm; P = .009). No significant racial differences in grade, operative, or systemic treatment were noted. Univariate analysis found no significant differences in disease-specific overall survival (DSS) or disease-free survival (DFS) between Caucasians and African Americans (5-year actuarial DSS, 93.6% vs 90.7%, respectively; P = .205; 5-year actuarial DFS, 91.5% vs 90.4%, respectively; P = .829). On multivariate analysis, only tumor size remained an independent predictor of DSS (odds ratio [OR], 1.021; 95% confidence interval [CI], 1.013-1.028; P < .001). Controlling for age, tumor size, and insurance status, race did not influence DSS or DFS (P = .913 and P = .857).

Conclusion: African Americans present with larger tumors than Caucasians; treatment is similar. Tumor size, not race, affects disease-specific outcomes in patients with breast cancer.

Publication types

  • Comparative Study

MeSH terms

  • Black or African American
  • Breast Neoplasms / metabolism
  • Breast Neoplasms / mortality*
  • Breast Neoplasms / pathology*
  • Disease-Free Survival
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Kentucky / epidemiology
  • Middle Aged
  • Multivariate Analysis
  • Neoplasms, Hormone-Dependent / metabolism
  • Neoplasms, Hormone-Dependent / mortality*
  • Neoplasms, Hormone-Dependent / pathology*
  • Prognosis
  • Proportional Hazards Models
  • Receptors, Estrogen / metabolism
  • Receptors, Progesterone / metabolism
  • Registries
  • White People

Substances

  • Receptors, Estrogen
  • Receptors, Progesterone