Racial/ethnic disparities in inflammatory breast cancer survival in the Michigan Cancer Surveillance Program

Gudina, Abdi; Copeland, Glenn; Soliman, Amr S.; Hirko, Kelly A.

doi:10.1007/s10549-018-5037-y

Cited by 12 publications

(7 citation statements)

References 28 publications

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“…Unfortunately, data on risk factors associated with this disease are limited. The NCR does not register ethnicity, BMI, and maternal age at first birth [ 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Pathologic complete response and overall survival in breast cancer subtypes in stage III inflammatory breast cancer

Uden

Maaren

Bult³

et al. 2019

Breast Cancer Res Treat

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Purpose To analyze the influence of hormone receptors (HR) and Human Epidermal growth factor Receptor-2 (HER2)-based molecular subtypes in stage III inflammatory breast cancer (IBC) on tumor characteristics, treatment, pathologic response to neoadjuvant chemotherapy (NACT), and overall survival (OS). Methods Patients with stage III IBC, diagnosed in the Netherlands between 2006 and 2015, were classified into four breast cancer subtypes: HR+/HER2− , HR+/HER2+ , HR−/HER2+ , and HR−/HER2−. Patient-, tumor-and treatment-related characteristics were compared. In case of NACT, pathologic complete response (pCR) was compared between subgroups. OS of the subtypes was compared using Kaplan-Meier curves and the log-rank test. Results 1061 patients with stage III IBC were grouped into subtypes: HR+/HER2− (N = 453, 42.7%), HR−/HER2− (N = 258, 24.3%), HR−/HER2+ (N = 180,17.0%), and HR+/HER2+ (N = 170,16.0%). In total, 679 patients (85.0%) received NACT. In HR−/HER2+ tumors, pCR rate was highest (43%, (p < 0.001). In case of pCR, an improved survival was observed for all subtypes, especially for HR+/HER2+ and HR−/HER2+ tumor subtypes. Trimodality therapy (NACT, surgery, radiotherapy) improved 5-year OS as opposed to patients not receiving this regimen: HR+/HER2− (74.9 vs. 46.1%), HR+/HER2+ (80.4 vs. 52.6%), HR−/HER2+ (76.4 vs. 29.7%), HR−/HER2− (47.6 vs. 27.8%). Conclusions In stage III IBC, breast cancer subtypes based on the HR and HER2 receptor are important prognostic factors of response to NACT and OS. Patients with HR−/HER2− IBC were less likely to achieve pCR and had the worst OS, irrespective of receiving most optimal treatment regimen to date (trimodality therapy).

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“…Unfortunately, data on risk factors associated with this disease are limited. The NCR does not register ethnicity, BMI, and maternal age at first birth [ 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Pathologic complete response and overall survival in breast cancer subtypes in stage III inflammatory breast cancer

Uden

Maaren

Bult³

et al. 2019

Breast Cancer Res Treat

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“…In addition, 30% of IBC patients present with metastatic disease, further underscoring the importance of a prompt diagnosis [35]. Most importantly, IBC is a NIH-designated cancer health disparity [26] with increased global incidence and mortality in minoritized and marginalized populations [20,37,38]. This is consistent with reports of distinct reproductive risk factors like younger age at rst pregnancy, multiparity, and breastfeeding in IBC [16] [28, 30].…”

Section: Introductionmentioning

confidence: 52%

Assessing Knowledge and Barriers at the Primary Care Provider Level that Contribute to Disparities in Inflammatory Breast Cancer Diagnosis and Treatment

Devi

Fish

Bennion

et al. 2022

Preprint

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Purpose: The purpose of this study was to evaluate knowledge gaps and barriers related to diagnosis and care of inflammatory breast cancer (IBC), a rare but most lethal breast cancer subtype, amongst Primary Care Providers (PCP) as they are often the first point of contact when patients notice initial symptoms. Methods: PCP participants within Duke University Health System, federally qualified health center, corporate employee health and community practices, nearby academic medical center, Duke physician assistant, and nurse leadership program alumni were first selected in a convenience sample (n=11) for semi-structured interviews (n=11). Based on these data, an online survey tool was developed and disseminated (n=78) to assess salient measures of IBC diagnosis, health disparity factors, referral and care coordination practices, COVID impact, and continued medical education (CME). Results: PCP reported access to care and knowledge gaps in symptom recognition (mean = 3.3, range 1-7) as major barriers. Only 31% reported ever suspecting IBC in a patient. PCP (n=49) responded being challenged with referral delays in diagnostic imaging. Additionally, since the COVID-19 pandemic started, 63% reported breast cancer referral delays, and 33% reported diagnosing less breast cancer. PCP stated interest in CME in their practice for improved diagnosis and patient care, which included online (53%), lunch time or other in-service training (33%), patient and provider-facing websites (32%). Conclusions: Challenges communicating rare cancer information, gaps in confidence in diagnosing IBC, and timely follow-up with patients and specialists underscores the need for developing PCP educational modules to improve guideline-concordant care.

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“…[7,16,19] However, other races have not reliably been shown to be independent poor prognostic factors in those with IBC. [19] One possible reason for this nding is that this could indicate unique disparities (e.g., biological variations) amongst Blacks with IBC that do not necessarily affect other races (including NH/PI race) regardless of the prevalence of the disease. However, given the rarity of IBC, small sample size again should also be considered when interpreting these results.…”

Section: Patient Characteristicsmentioning

confidence: 99%

“…Previous studies have consistently shown that for those with IBC, Black race is associated with poor prognosis. [7,16,19] However, other races have not reliably been shown to be independent poor prognostic factors in those with IBC. [19] One possible reason for this nding is that this could indicate unique disparities (e.g., biological variations) amongst Blacks with IBC that do not necessarily affect other races (including NH/PI race) regardless of the prevalence of the disease.…”

Section: Patient Characteristicsmentioning

confidence: 99%

Racial and Survival Disparities in Inflammatory Breast Cancer (IBC) and non-IBC: A Population-Based Study Focused on Native Hawaiians and Other Pacific Islanders

Yoshikawa,

Miyazaki,

Acoba

et al. 2023

Preprint

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Background Breast cancer has the highest incidence among all malignancies and is the second leading cause of cancer death among women in the United States. It is well known that race is an independent predictor of breast cancer mortality and advanced stage at diagnosis. Inflammatory breast cancer (IBC) is the most aggressive type of breast cancer and has distinct clinical and biological features. Previous studies have shown that Blacks have a higher incidence of IBC than Whites. However, the proportion of IBC and the role of race on prognosis in Native Hawaiian and other Pacific Islander (NH/PI) populations with breast cancer are poorly understood. In this study, we aimed to examine the proportion of IBC to non-IBC in NH/PIs and to identify the clinicopathological, biological, and socioeconomic factors associated with the overall survival of NH/PIs compared to other races. Methods Utilizing a comprehensive cancer registry from the largest hospital in Hawaii, newly diagnosed primary invasive breast cancer patients diagnosed between 2000 and 2018 were identified. Univariate and multivariate Cox proportional hazards models were used to test the association between race and clinical outcomes. Variables with P-values <0.05 in the univariate analysis and race (variable of interest) were included in a multivariate analysis. Results The cohort included 3691 patients, 60 of whom had IBC. NH/PI race had the highest proportion of IBC compared to other races (3.44%) but was not found to be an independent poor prognostic factor in IBC (HR 1.17 [95%CI 0.26-5.22]). Conversely, NH/PI race was associated with worse survival outcomes in patients with non-IBC (HR 1.65 [95%CI, 1.14-2.39]) along with other factors such as lack of insurance, underinsured status, triple-negative breast cancer (TNBC) subtype, age, and advanced clinical stage. Conclusions The findings of this study highlight that NH/PIs had higher rates of IBC and inferior survival in non-IBC compared to other races but not in IBC. It is essential to disaggregate NH/PI race from Asians in future population-based research studies. Further research is needed to understand the factors contributing to higher rates of IBC and poor survival outcomes in NH/PIs with non-IBC as well as targeted interventions to improve breast cancer outcomes in this population to ultimately help improve survival rates and reduce health inequities in NH/PIs with breast cancer.

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Racial/ethnic disparities in inflammatory breast cancer survival in the Michigan Cancer Surveillance Program

Cited by 12 publications

References 28 publications

Pathologic complete response and overall survival in breast cancer subtypes in stage III inflammatory breast cancer

Pathologic complete response and overall survival in breast cancer subtypes in stage III inflammatory breast cancer

Assessing Knowledge and Barriers at the Primary Care Provider Level that Contribute to Disparities in Inflammatory Breast Cancer Diagnosis and Treatment

Racial and Survival Disparities in Inflammatory Breast Cancer (IBC) and non-IBC: A Population-Based Study Focused on Native Hawaiians and Other Pacific Islanders

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