title: Does race affect outcomes in triple negative breast cancer?
abstract: BACKGROUND
  There is discordance among studies assessing the impact of race on outcome of patients with Triple Negative Breast Cancer (TNBC). We assessed survival outcomes for African American (AA) versus Caucasian (CA) women with TNBC treated at an urban cancer center in Memphis, TN with a predominant AA patient population.
  
  
  METHODS
  Patients with Stage I-III TNBC were identified from our breast database. Event free survival (EFS) and Breast cancer specific survival (BCSS) were the primary outcome measures. Cox proportional hazards models were fitted for EFS and BCSS.
  
  
  RESULTS
  Of the 124 patients, 71% were AA. No significant association between race and stage (P = 0.21) or menopausal status (P = 0.15) was observed. Median age at diagnosis was significantly lower for AA versus CA women (49.5 vs. 55 years, P = 0.024). 92% of the patients received standard neo/adjuvant chemotherapy, with no significant difference in duration and type of chemotherapy between the races. With a median follow up of 23 months, 28% of AA vs. 19% of CA women had an event (P = 0.37). 3 year EFS and BCSS trended favorably towards CA race (77% vs. 64%, log rank P = 0.20 and 92% vs. 76%, P = 0.13 respectively) with a similar trend noted on multiple variable modeling (EFS: HR 0.62, P = 0.29; BCSS: HR 0.36, P = 0.18). AA women >/=50 years at diagnosis had a significantly worse BCSS than the CA women in that age group (P = 0.012).
  
  
  CONCLUSIONS
  Older AA women with TNBC have a significantly worse breast cancer specific survival than their CA counterparts. Overall, there is a trend towards lower survival for AA women compared to Caucasians despite uniformity of tumor phenotype and treatment. The high early event rate, irrespective of race, underscores the need for effective therapies for women with TNBC.
authors.affiliation: University of Tennessee Health Science Center Memphis, TN.
authors.forename: Jasgit C
authors.initials: JC
authors.lastname: Sachdev
authors.forename: Saira
authors.initials: S
authors.lastname: Ahmed
authors.forename: Muhammad M
authors.initials: MM
authors.lastname: Mirza
authors.forename: Aamer
authors.initials: A
authors.lastname: Farooq
authors.forename: Lori
authors.initials: L
authors.lastname: Kronish
authors.forename: Mohammad
authors.initials: M
authors.lastname: Jahanzeb