title: Prevalence and prognostic role of triple-negative breast cancer by race: a surveillance study.
abstract: BACKGROUND
  Emerging research suggests a substantially greater prevalence of the adverse triple-negative (TN) subtype (human epidermal growth factor receptor [HER]2(-), estrogen receptor [ER](-), and progesterone receptor [PR])(-)) among black patients with breast cancer. No reports however have been generated from a statewide cancer registry.
  
  
  METHODS
  The study consisted of all black patients (N = 643) and a random sample of white patients (n = 719) diagnosed with primary invasive breast cancer (2000-2003) listed in the National Cancer Institute-Surveillance Epidemiology and End Results (NCI-SEER) Connecticut Tumor Registry (CTR). HER2 status was obtained from pathology reports submitted to the registry. Remaining data were obtained from the registry database.
  
  
  RESULTS
  TN tumors were more prevalent in black compared with white patients (30.8% vs. 11.2%, respectively; P < .001.) There was a 2-fold greater frequency of ER(-) and PR(-) phenotypes among black patients, but HER2 status did not differ by race. Patients with lobular cancer were less likely to have TN breast cancer compared with patients with ductal tumors (odds ratio [OR] = 0.23; 95% confidence interval [CI], 0.10-0.58). Among patients with regional disease, black patients exhibited increased risk of death (relative risk [RR] = 2.71; 95% CI, 1.48-4.97) independent of TN status. No survival disparity was found among patients with local disease.
  
  
  CONCLUSIONS
  These registry-based data corroborate reports that TN breast cancer varies substantially by race and histologic subtype. A survival disparity among patients with advanced disease, but not local disease, casts some doubt on TN status as an explanation for differences.
  
  
  CONCLUSIONS
  More research is warranted to understand why black patients with advanced breast cancer may be at increased risk for death whether or not their tumors express the TN phenotype.
authors: Department of Community Medicine & Health Care, University of Connecticut School of Medicine, Farmington, CT 06030, USA. hswede@uchc.edu
authors: Helen
authors: H
authors: Swede
authors: David I
authors: DI
authors: Gregorio
authors: Susan H
authors: SH
authors: Tannenbaum
authors: Jessica A
authors: JA
authors: Brockmeyer
authors: Christine
authors: C
authors: Ambrosone
authors: Lori L
authors: LL
authors: Wilson
authors: Mellisa A
authors: MA
authors: Pensa
authors: Lou
authors: L
authors: Gonsalves
authors: Richard G
authors: RG
authors: Stevens
authors: Carolyn D
authors: CD
authors: Runowicz
mesh_terms: D001943:Breast Neoplasms / Q000453:epidemiology* / Q000208:ethnology / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000453:epidemiology / Q000208:ethnology / Q000473:pathology; D018275:Carcinoma, Lobular / Q000453:epidemiology / Q000208:ethnology / Q000473:pathology; D018276:Carcinoma, Medullary / Q000453:epidemiology / Q000208:ethnology / Q000473:pathology; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D015995:Prevalence; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D018426:SEER Program; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone