Black Patients More Likely to Die From Triple-Negative Breast Cancer

By Cara Jones

African American women with nonmetastatic triple-negative breast cancer (TNBC) have a significantly higher risk for breast cancer mortality versus White patients, according to a study published online in JAMA Oncology. Black women also tend to be younger at triple-negative breast cancer diagnosis. Their average age of developing triple-negative breast cancer is 56.3 years old while white women get diagnosed around 59.7 years old, the study found.

The study was conducted by Beomyoung Cho, Ph.D., from the Washington University School of Medicine in St. Louis, and colleagues.

They used the Surveillance, Epidemiology, and End Results dataset to identify 23,213 women (25.3 percent African American and 74.7 percent White) who received a diagnosis of nonmetastatic TNBC in 2010 through 2015 with follow-up through 2016.

The researchers found that compared with White patients, African American patients had lower odds of receiving surgery (odds ratio [OR], 0.69) and chemotherapy (OR, 0.89) after adjusting for sociodemographic, clinicopathologic, and county-level factors.

During the 43 months of follow-up, 14.2 percent of patients died of breast cancer. An adjusted analysis that shows Black patients’ risk for breast cancer mortality has a higher hazard ratio [HR] of 1.28.

A hazard ratio is an estimate of the ratio of the hazard rate.

The HR dropped to 1.16 with further adjustment for clinicopathological and treatment factors.

However, there was still a higher risk for patients living in socioeconomically less deprived counties (HR, 1.26), urban patients (HR, 1.21), patients having stage II (HR, 1.19) or III (HR, 1.15) tumors that were treated with chemotherapy, and patients younger than 65 years (HR, 1.24).

“The risk of death of breast cancer remained significantly higher in African American women compared with White women after adjustment for demographic, health insurance, neighborhood, clinicopathological, and treatment factors,” the authors write.

Prevention

Because triple-negative breast cancer can be so deadly for Black women, it is important that you know the best way to prevent yourself from developing it:

• Healthy Lifestyle: A healthy lifestyle is the best way to avoid this deadly disease. Make sure you are getting a balanced diet, limiting your alcohol intake and exercising regularly.
• Breast Feeding: Women who recently gave birth or are expecting should consider breastfeeding. Breastfeeding for at least several months can reduce women’s risk of developing cancer.
• Speak with your doctor: Know your family history if possible. If you have a higher chance of developing cancer, speak with your doctor to understand the risk and discuss methods of prevention.
• Genetic testing: A genetic test can tell you if you have BRCA gene mutations and are more susceptible to cancer.
• Breast cancer chemoprevention: You can try medicines such as tamoxifen, raloxifene and aromatase inhibitors designed to reduce your risk of developing cancer.
• Screenings: Make sure you are receiving age-appropriate screenings. This is the best way to detect cancer at an early stage for a better survival rate. You can also get additional screenings like an MRI.
• Preventive (prophylactic) bilateral mastectomy
• Prophylactic oophorectomy (ovary removal)