Impact of race/ethnicity on MammaPrint genomic assay risk and prognosis in early breast cancer: A National Cancer Data Base analysis

IF 5.1 2区医学 Q1 ONCOLOGY Cancer Pub Date : 2025-02-27 DOI:10.1002/cncr.35771

Rima B. Patel MD, Tianxiang Sheng MSc, Marcio A. Diniz PhD, Joseph A. Sparano MD, Amy Tiersten MD

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Abstract

Background

Black race is associated with poorer prognosis in hormone receptor (HR)–positive, HER2-negative early breast cancer (EBC). The impact of race/ethnicity on the risk distribution and prognostic information provided by the 70-gene MammaPrint assay was evaluated.

Methods

Women with HR-positive EBC with tumors up to 5 cm in size and zero to three involved lymph nodes, who were diagnosed between 2009 and 2018, and who had an available MammaPrint result were identified in the National Cancer Data Base (NCDB). t-tests and χ² tests were used to compare patient characteristics, whereas log-rank tests assessed differences in overall survival (OS) between racial/ethnic subgroups.

Results

Of the 6137 women included, 82.8% (n = 5084) were non-Hispanic White, 8.9% (n = 545) were non-Hispanic Black (NHB), 4.8% (n = 292) were Hispanic, and the remainder were other/unknown (n = 216). Of these women, 58.4% (n = 3587) were MammaPrint low risk and 41.6% (n = 2550) were MammaPrint high risk. NHB and Hispanic women were more likely to have a high-risk MammaPrint result (p < .001) than other racial/ethnic subgroups. Five-year OS was worse for the MammaPrint high-risk versus low-risk group (92.6% vs. 96.6%; p < .0001). There were no significant differences in OS on the basis of race/ethnicity in the MammaPrint low-risk (p = .34) or high-risk (p = .79) subgroups. However, Black race did not affect mortality in the overall population (hazard ratio, 1.15; 95% confidence interval, 0.84–1.58).

Conclusions

NHB and Hispanic women were more likely to have high-risk MammaPrint results in this NCDB cohort. Although there were no differences in survival by race/ethnicity in the MammaPrint low- and high-risk groups, these findings are limited by the lack of association between race/ethnicity and mortality in the overall population when adjusting for other clinicopathologic prognostic covariates.

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种族/民族对早期乳腺癌的MammaPrint基因组测定风险和预后的影响：国家癌症数据库分析

在激素受体（HR）阳性、her2阴性的早期乳腺癌（EBC）中，黑人与预后较差相关。评估种族/民族对风险分布和70基因MammaPrint检测提供的预后信息的影响。方法在美国国家癌症数据库（NCDB）中确定2009年至2018年间诊断的hrc阳性EBC患者，肿瘤大小达5cm，无至3个受病灶淋巴结，并且具有可用的MammaPrint结果。使用t检验和χ2检验比较患者特征，而对数秩检验评估种族/民族亚组之间总生存期（OS）的差异。结果纳入的6137名妇女中，82.8% （n = 5084）为非西班牙裔白人，8.9% （n = 545）为非西班牙裔黑人（NHB）， 4.8% （n = 292）为西班牙裔，其余为其他/未知（n = 216）。在这些女性中，58.4% （n = 3587）为mamaprint低风险，41.6% （n = 2550）为mamaprint高风险。NHB和西班牙裔女性更有可能出现高风险的MammaPrint结果(p <；.001)比其他种族/族裔亚群。5年OS在mamaprint高危组比低危组更差(92.6%比96.6%；p & lt;。)。在mamaprint低风险（p = 0.34）和高风险（p = 0.79）亚组中，基于种族/民族的OS无显著差异。然而，黑人种族对总体人口的死亡率没有影响(风险比，1.15；95%置信区间为0.84-1.58)。结论：在NCDB队列中，NHB和西班牙裔女性更有可能出现高危的MammaPrint结果。尽管在mamaprint低高危组和高危组中，种族/民族生存率没有差异，但在调整其他临床病理预后协变量时，这些发现受到总体人群中种族/民族与死亡率之间缺乏关联的限制。

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来源期刊

Cancer 医学-肿瘤学

CiteScore

13.10

自引率

3.20%

发文量

480

审稿时长

2-3 weeks

期刊介绍： The CANCER site is a full-text, electronic implementation of CANCER, an Interdisciplinary International Journal of the American Cancer Society, and CANCER CYTOPATHOLOGY, a Journal of the American Cancer Society. CANCER publishes interdisciplinary oncologic information according to, but not limited to, the following disease sites and disciplines: blood/bone marrow; breast disease; endocrine disorders; epidemiology; gastrointestinal tract; genitourinary disease; gynecologic oncology; head and neck disease; hepatobiliary tract; integrated medicine; lung disease; medical oncology; neuro-oncology; pathology radiation oncology; translational research