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- Title
Racial Differences in PAM50 Subtypes in the Carolina Breast Cancer Study.
- Authors
Troester, Melissa A.; Xuezheng Sun; Allott, Emma H.; Geradts, Joseph; Cohen, Stephanie M.; Chiu-Kit Tse; Kirk, Erin L.; Thorne, Leigh B.; Mathews, Michelle; Yan Li; Zhiyuan Hu; Robinson, Whitney R.; Hoadley, Katherine A.; Olopade, Olufunmilayo I.; Reeder-Hayes, Katherine E.; Earp, H. Shelton; Olshan, Andrew F.; Carey, Lisa A.; Perou, Charles M.
- Abstract
<bold>Background: </bold>African American breast cancer patients have lower frequency of hormone receptor-positive (HR+)/human epidermal growth factor receptor 2 (HER2)-negative disease and higher subtype-specific mortality. Racial differences in molecular subtype within clinically defined subgroups are not well understood.<bold>Methods: </bold>Using data and biospecimens from the population-based Carolina Breast Cancer Study (CBCS) Phase 3 (2008-2013), we classified 980 invasive breast cancers using RNA expression-based PAM50 subtype and recurrence (ROR) score that reflects proliferation and tumor size. Molecular subtypes (Luminal A, Luminal B, HER2-enriched, and Basal-like) and ROR scores (high vs low/medium) were compared by race (blacks vs whites) and age (≤50 years vs > 50 years) using chi-square tests and analysis of variance tests.<bold>Results: </bold>Black women of all ages had a statistically significantly lower frequency of Luminal A breast cancer (25.4% and 33.6% in blacks vs 42.8% and 52.1% in whites; younger and older, respectively). All other subtype frequencies were higher in black women (case-only odds ratio [OR] = 3.11, 95% confidence interval [CI] = 2.22 to 4.37, for Basal-like; OR = 1.45, 95% CI = 1.02 to 2.06, for Luminal B; OR = 2.04, 95% CI = 1.33 to 3.13, for HER2-enriched). Among clinically HR+/HER2- cases, Luminal A subtype was less common and ROR scores were statistically significantly higher among black women.<bold>Conclusions: </bold>Multigene assays highlight racial disparities in tumor subtype distribution that persist even in clinically defined subgroups. Differences in tumor biology (eg, HER2-enriched status) may be targetable to reduce disparities among clinically ER+/HER2- cases.
- Subjects
PROTEIN analysis; RNA analysis; ANTHROPOMETRY; BLACK people; BREAST tumors; CELL physiology; CELL receptors; RESEARCH funding; WHITE people; DISEASE relapse
- Publication
JNCI: Journal of the National Cancer Institute, 2018, Vol 110, Issue 2, p1
- ISSN
0027-8874
- Publication type
Article
- DOI
10.1093/jnci/djx135