Racial Differences in Breast Cancer 21-Gene Recurrence Scores
In a study reported in the Journal of Clinical Oncology, Holowatyj et al found that among women with hormone receptor–positive, HER2-negative, node-negative invasive breast cancer, non-Hispanic black women had higher 21-gene recurrence scores at diagnosis vs non-Hispanic white women.
Study Details
The study involved data on recurrence score testing (10-year risk of distant recurrence = low for score ≤ 18, intermediate for 18–30, and high for ≥ 31) among 1,824 non-Hispanic white women and 392 non-Hispanic black women from the Metropolitan Detroit Cancer Surveillance System between 2010 and 2014.
Recurrence Scores
Among all patients, mean recurrence score was 19.3 in non-Hispanic black women vs 17.0 in non-Hispanic white women (P = .0003), and non-Hispanic black women were more likely to present with high-risk tumors (14.8% vs 8.3%, P = .0004). The differences in recurrence scores were limited to patients aged < 65 years at diagnosis: mean recurrence score was 23.6 vs 17.3 (P < .001) among patients aged 20 to 49 years and 19.6 vs 17.4 (P = .023) among those aged 50 to 64 years. On analysis adjusting for age, clinical stage, tumor grade, and histology, non-Hispanic black women remained significantly more likely to have high-risk tumors (odds ratio [OR] = 1.75, 95% confidence interval = 1.18–2.59).
The investigators concluded, “[Non-Hispanic black patients] who met clinical criteria for 21-gene [recurrence score] testing had tumors with higher estimated risks of distant recurrence compared with [non-Hispanic white patients]. Further study is needed to elucidate whether differences in recurrence are observed for these women, which would have clinical implications for 21-gene [recurrence score] calibration and treatment recommendations in [Non-Hispanic black] patients.”
The study was supported by Komen for the Cure; an Epidemiology Core, Health, and Human Services contract; and a grant from the National Institutes of Health.
Kristen S. Purrington, PhD, MPH, of Wayne State University School of Medicine, is the corresponding author for the Journal of Clinical Oncology article.
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