Racial and regional disparities of triple negative breast cancer incidence rates in the United States: An analysis of 2011–2019 NPCR and SEER incidence data

Abstract

ObjectiveTriple negative breast cancer (TNBC) is a more aggressive subtype resistant to conventional treatments with a poorer prognosis. This study was to update the status of TNBC and the temporal changes of its incidence rate in the US.MethodsWomen diagnosed with breast cancer during 2011–2019 were obtained from the National Program of Cancer Registries (NPCR) and Surveillance, Epidemiology and End Results (SEER) Program SEER*Stat Database which covers the entire population of the US. The TNBC incidence and its temporal trends by race, age, region (state) and disease stage were determined during the period.ResultsA total of 238,848 (or 8.8%) TNBC women were diagnosed during the study period. TNBC occurred disproportionally higher in women of Non-Hispanic Black, younger ages, with cancer at a distant stage or poorly/undifferentiated. The age adjusted incidence rate (AAIR) for TNBC in all races decreased from 14.8 per 100,000 in 2011 to 14.0 in 2019 (annual percentage change (APC) = −0.6, P = 0.024). Incidence rates of TNBC significantly decreased with APCs of −0.8 in Non-Hispanic White women, −1.3 in West and −0.7 in Northeastern regions. Women with TNBC at the age of 35–49, 50–59, and 60–69 years, and the disease at the regional stage displayed significantly decreased trends. Among state levels, Mississippi (20.6) and Louisiana (18.9) had the highest, while Utah (9.1) and Montana (9.6) had the lowest AAIRs in 2019. New Hampshire and Indiana had significant and highest decreases, while Louisiana and Arkansas had significant and largest increases in AAIR. In individual races, TNBC displayed disparities in temporal trends among age groups, regions and disease stages. Surprisingly, Non-Hispanic White and Hispanic TNBC women (0–34 years), and Non-Hispanic Black women (≥70 years) during the entire period, as well as Asian or Pacific Islander women in the South region had increased trends between 2011 and 2017.ConclusionOur study demonstrates an overall decreased trend of TNBC incidence in the past decade. Its incidence displayed disparities among races, age groups, regions and disease stages. Special attention is needed for a heavy burden in Non-Hispanic Black and increased trends in certain groups.

Racial/Ethnic Disparities in Pathologic Complete Response and Overall Survival in Patients With Triple-Negative Breast Cancer Treated With Neoadjuvant Chemotherapy

“…1 While socioeconomic factors and access to treatment play a role, [2][3][4][5][6][7][8][9] emerging data suggest that differences in tumor biology may also contribute. [10][11][12][13] NHB women appear to develop triple-negative breast cancer (TNBC), the most aggressive subtype of breast cancer, at twice the rate of NHW, 14,15 and they have a third higher risk of dying from this disease. 4,16,17 TNBC is defined by the absence of estrogen receptor expression, progesterone receptor expression, and human epidermal growth factor receptor 2 (HER2) overexpression.…”

“…1 While socioeconomic factors and access to treatment play a role, 2-9 emerging data suggest that differences in tumor biology may also contribute. 10-13 NHB women appear to develop triple-negative breast cancer (TNBC), the most aggressive subtype of breast cancer, at twice the rate of NHW, 14,15 and they have a third higher risk of dying from this disease. 4,16,17…”

Immunohistochemistry-based molecular subtyping of triple-negative breast cancer and its prognostic significance

“…Triple-negative breast cancer (TNBC) is characterized by the lack of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2), accounting for approximately 15%-20% of all breast cancers [2]. Studies have discovered ethnic variations in TNBC prevalence and clinical behavior, possibly owing to disease heterogeneity and genetic variations among races [3,4]. Patients with TNBC are younger and have a worse prognosis with a higher relapse rate than non-TNBC [5].…”

The disparities in prognostic prediction and annualized hazard function in different molecular subtypes between young Chinese and White American women with breast cancer

“…Nevertheless, the prognostic disparities in molecular subtypes among young breast cancer patients of diverse race/ethnicity backgrounds remain unclear. A few research have examined the disparities of race/ethnicity in survival when considering modern tumor subtypes among young women ( 8 , 26 , 27 ). However, due to inadequate inclusion of women from Asian or other ethnic groups, or focusing solely on a specific subtype, such as triple-negative tumors, these studies have not comprehensively described disparities in survival across races/ethnicities in various subtypes of breast cancer ( 8 , 26 , 27 ).…”

“…A few research have examined the disparities of race/ethnicity in survival when considering modern tumor subtypes among young women ( 8 , 26 , 27 ). However, due to inadequate inclusion of women from Asian or other ethnic groups, or focusing solely on a specific subtype, such as triple-negative tumors, these studies have not comprehensively described disparities in survival across races/ethnicities in various subtypes of breast cancer ( 8 , 26 , 27 ). Given the rising incidence of breast cancer among young Chinese women, it is essential to explore prognostic differences in subtypes between young Chinese women and other ethnicities.…”