Black Breast Cancer Patients Have Worse Outcomes than Whites, Even With Similar Treatments
Loyola Medicine Researcher Kathy Albain, MD, is Lead Author of Large International Study
MAYWOOD, IL – Black women with the most common form of early breast cancer had worse outcomes than white women even after receiving equivalent care, according to a major new study led by Loyola Medicine medical oncologist Kathy Albain, MD, FACP, FASCO.
Dr. Albain presented findings of the international study at the San Antonio Breast Cancer Symposium.
"The study adds to an emerging body of evidence suggesting there are biological factors contributing to racial disparities in breast cancer outcomes," Dr. Albain said. She added that researchers will be conducting additional studies on tumor samples donated by patients enrolled in the trial.
Dr. Albain is among the nation's leading breast cancer researchers. She is the Huizenga Family Endowed Chair in Oncology Research and a professor in the department of medicine, division of hematology/oncology, of Loyola University Chicago Stritch School of Medicine.
Dr. Albain and colleagues evaluated data from the TAILORx clinical trial, which included more than 10,000 women with hormone receptor-positive, HER2-negative breast cancer that had not spread to lymph nodes. The study found that after nine years of follow-up, 83.1 percent of white women were alive with no recurrence of invasive breast cancer. By comparison, only 78.9 percent of black women were alive and cancer-free. Hispanic women had a prognosis similar to or better than that of non-Hispanic women.
Dr. Albain was a main author of the initial report of the TAILORx trial, which found that the 21-gene test could enable most patients with the most common type of early breast cancer to safely forgo chemotherapy. That study found that women whose tumors had mid-range recurrence scores did not need or benefit from chemotherapy.
An important result of this new study is that women of all races and ethnicities, when analyzed separately, could safely avoid chemotherapy. The current study found that the type and duration of chemotherapy and hormone therapy treatments were similar among black and white women and other races as well as between Hispanic and non-Hispanic women. Pathologic characteristics of the tumors were no different as well.
There also were no significant differences between black and white women in their tumor's "recurrence score," a measure of how likely the cancer will recur in distant organs. The score, which ranges from 0 to 100, is based on a test of 21 genes from a patient's tumor.
"The racial disparities observed in this trial were not explained by differences in recurrence score or reported duration of antihormonal endocrine therapy," Dr. Albain said. "Nor were the differences explained by the type of chemotherapy (if used) or characteristics such as age, tumor size or grade. As such, our results suggest that biological differences may contribute to the significantly different outcomes of black women compared to others with breast cancer."
TAILORx was sponsored by the National Cancer Institute and designed and led by the ECOG-ACRIN Cancer Research Group. It also was supported by the Canadian Cancer Research Society, Breast Cancer Research Foundation, Susan G. Komen for the Cure and the U.S. Postal Service Breast Cancer Research Stamp.
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Loyola Medicine is a quaternary care system based in the western suburbs of Chicago that includes Loyola University Medical Center (LUMC) in Maywood, Gottlieb Memorial Hospital (GMH) in Melrose Park, MacNeal Hospital in Berwyn and convenient locations offering primary and specialty care services from 1,772 physicians throughout Cook, Will and DuPage counties. LUMC is a 547-licensed-bed hospital that includes the William G. and Mary A. Ryan Center for Heart & Vascular Medicine, the Cardinal Bernardin Cancer Center, a Level 1 trauma center, Illinois's largest burn center, a certified comprehensive stroke center and a children’s hospital. The medical center campus is also home to Loyola University Chicago Stritch School of Medicine, Loyola University Chicago Marcella Niehoff School of Nursing and the Loyola Center for Fitness. GMH is a 247-licensed-bed community hospital with 150 physician offices, an adult day care program, the Gottlieb Center for Fitness, the Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park. MacNeal Hospital is a 374-bed teaching hospital with advanced inpatient and outpatient medical, surgical and psychiatric services, advanced diagnostics and treatments in a convenient community setting at eight locations. Loyola Medicine is a member of Trinity Health, one of the nation’s largest health systems with 94 hospitals in 22 states.
About Trinity Health
Trinity Health is one of the largest multi-institutional Catholic health care delivery systems in the nation. It serves people and communities in 22 states from coast to coast with 94 hospitals, and 109 continuing care locations — including home care, hospice, PACE and senior living facilities - that provide more than 107,000 home health and hospice admissions.
The organization was formed in May 2013, when Trinity Health and Catholic Health East officially came together to strengthen their shared mission, increase excellence in care and advance transformative efforts with our unified voice. With annual operating revenues of $17.6 billion and assets of $23.4 billion, the new organization returns $1.1 billion to its communities annually in the form of charity care and other community benefit programs.
Trinity Health employs more than 133,000 colleagues, including 7,500 employed physicians and clinicians. Committed to those who are poor and underserved in its communities, Trinity Health is known for its focus on the country's aging population. As a single, unified ministry, the organization is the innovator of Senior Emergency Departments, the largest not-for-profit provider of home health care services — ranked by number of visits — in the nation, as well as the nation’s leading provider of PACE (Program of All Inclusive Care for the Elderly) based on the number of available programs.