Racial/ethnic differences in breast cancer survival by inflammatory status and hormonal receptor status: an analysis of the Surveillance, Epidemiology, and End Results data.
BACKGROUND
Compared to non-inflammatory breast cancer (non-IBC), inflammatory breast cancer (IBC) has less favorable survival and is more likely to be estrogen receptor (ER) and progesterone receptor (PR) negative. ER-/PR- tumors, regardless of histology, have less favorable survival. While black women are more likely to have IBC and ER-/PR- tumors than white women, it is unclear whether the racial disparity in survival is explained by these factors. The objective of this study was to assess racial/ethnic differences in breast cancer survival by inflammatory status and hormone receptor status.


METHODS
This study examined breast cancer mortality among non-Hispanic white (NHW), Hispanic white, black, and Asian/Pacific Islander (API) women diagnosed between 1990 and 2004 using the National Cancer Institute's Surveillance, Epidemiology, and End Results data. Kaplan-Meier survival curves and Cox proportional hazard ratios (HRs) assessed the relationship between race/ethnicity and survival.


RESULTS
Black women had significantly poorer survival than NHW women regardless of inflammatory status and hormone receptor status. Compared to NHWs, the HRs for black women were 1.32 (95 % confidence interval (CI) 1.21-1.44), 1.43 (95 % CI 1.20-1.69), and 1.30 (95 % CI 1.16-1.47) for IBC, IBC with ER+/PR+, and with ER-/PR-, respectively. Similar HRs were found for non-IBC, non-IBC with ER+/PR-, and non-IBC with ER-/PR-. API women had significantly better survival than NHW women regardless of inflammatory status and hormone receptor status.


CONCLUSIONS
Compared to NHW women, black women had poorer survival regardless of inflammatory status and hormone receptor status and API women had better survival. These results suggest that factors other than inflammatory status and hormone receptor status may play a role in racial/ethnic disparities in breast cancer survival.
John P. Murtha Cancer Center, Walter Reed National Military Medical Center, Bethesda, MD, USA, jschinkel@hjfresearch.org.
Jill K
JK
Schinkel
Shelia Hoar
SH
Zahm
Ismail
I
Jatoi
Katherine A
KA
McGlynn
Christopher
C
Gallagher
Catherine
C
Schairer
Craig D
CD
Shriver
Kangmin
K
Zhu
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D044466:Asian People; D001943:Breast Neoplasms / Q000208:ethnology* / Q000378:metabolism / Q000401:mortality* / Q000473:pathology; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D058922:Inflammatory Breast Neoplasms / Q000208:ethnology* / Q000378:metabolism / Q000401:mortality* / Q000473:pathology; D008875:Middle Aged; D044468:Native Hawaiian or Pacific Islander; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D018426:SEER Program; D014481:United States / Q000453:epidemiology; D044465:White People; D055815:Young Adult
D011960:Receptors, Estrogen; D011980:Receptors, Progesterone