Few studies documenting the benefit of neoadjuvant chemotherapy for breast cancer have been conducted in minority populations. A single-institution study reported at PER's Miami Breast Cancer Conference, held virtually this year, confirmed that neoadjuvant chemotherapy improved axillary disease in Hispanic women and reduced tumor size in Black women (Poster 37).
Michelle Cholankeril, MD, and colleagues from Trinitas Regional Medical Center at Rutgers New Jersey Medical School, noted that “very few studies delineate response in Hispanic and African American [patients].” They therefore conducted a study of 37 women with HER2-positive nonmetastatic breast cancer diagnosed from 2015 to 2019 at a single-center community program serving a minority population. The population makeup was 88% Hispanic and Black. More than half the patients received a neoadjuvant chemotherapy regimen that included trastuzumab alone or with pertuzumab.
The overall complete response rate to neoadjuvant chemotherapy was 48%, with 52% of patients achieving a partial response. The table shows these rates by racial group, along with proportions undergoing sentinel lymph node dissection, axillary dissection, partial mastectomy, and modified radical mastectomy (Table 1).
Table 1. Outcomes of Neoadjuvant Chemotherapy in Minority Population
| Neoadjuvant Chemotherapy Outcome | Hispanic Patients | Black Patients |
| Partial response (%) | 55 | 71 |
| Complete response (%) | 45 | 29 |
| Sentinel lymph node dissection (%) | 64 | 40 |
| Axillary lymph node dissection (%) | 36 | 60 |
| Partial mastectomy (%) | 55 | 71 |
| Modified radical mastectomy (%) | 45 | 29 |
Hispanic patients were found to have significantly more sentinel lymph node dissections performed vs axillary lymph node dissections following neoadjuvant chemotherapy, suggesting improved axillary response. Black women were found to have a greater reduction in breast tumor size, which led to more partial mastectomies compared to modified radical mastectomies, the authors indicated.
“This is an interesting phenomenon and a larger sample size from a multi-institutional trial that focuses on this population could further confirm these findings...We should further characterize response in minority populations,” they wrote.
Disclosures: Dr. Cholankeril reported no potential conflicts of interest.
