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05-09-2023 | Breast Cancer | Breast Oncology

Racial Disparities in Locoregional Recurrence in Postmenopausal Patients with Stage I–III, Hormone Receptor-Positive Breast Cancer Enrolled in the NSABP B-42 Clinical Trial

Authors: Charity C. Glass, MD, MPP, Robert M. Pride, MD, Rachel A. Freedman, MD, MPH, Erica L. Mayer, MD, MPH, Esther R. Ogayo, BS, Mariana Chavez-MacGregor, MD, MSc, Tari A. King, MD, Elizabeth A. Mittendorf, MD, PhD, MHCM, Olga Kantor, MD

Published in: Annals of Surgical Oncology | Issue 13/2023

Abstract

Background

There are limited data examining racial disparities in locoregional recurrence (LRR) among women with access to high-quality care. We aimed to examine differences in late LRR by race in patients with stage I–IIIA, hormone receptor-positive (HR+) breast cancer enrolled in the National Surgical Adjuvant Breast and Bowel (NSABP) B-42 trial.

Methods

From 2006 to 2010, 3966 postmenopausal women with stage I–IIIA HR+ breast cancer who were disease-free after 5 years of endocrine therapy were randomized to an additional 5 years of endocrine therapy or placebo. Patients were excluded if multi-racial or if race was unknown. Kaplan–Meier curves were used to estimate 6-year LRR from the time of trial registration and according to race. Cox proportional hazards models were used for adjusted survival analyses.

Results

Overall, 3929 NSABP B-42 patients were included: 3688 (93.9%) White, 151 (3.8%) Black, and 90 (2.3%) Asian patients. Median follow-up was 75.2 months. Overall estimated 6-year LRR from trial registration was 1.8% and differed by race: LRR rates were 1.7% in White women, 4.9% in Black women, and 0% in Asian women (p = 0.046). Adjusted Cox proportional hazards analysis found Black race to be independently associated with LRR (hazard ratio [HzR] 2.36, 95% confidence interval [CI] 1.01–5.49; p = 0.047). Node-positivity was also associated with increased LRR (HzR 1.75, 95% CI 1.07–2.86; p = 0.025). Adjusted Cox analysis found LRR (HzR 2.32, 95% CI 1.33–4.06; p = 0.003) to be associated with increased overall mortality; however, race was not independently associated with mortality.

Conclusion

Among postmenopausal patients with stage I–IIIA HR+ breast cancer in the NSABP B-42 trial, racial differences in late LRR were present, with the highest LRR in Black women.

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Title: Racial Disparities in Locoregional Recurrence in Postmenopausal Patients with Stage I–III, Hormone Receptor-Positive Breast Cancer Enrolled in the NSABP B-42 Clinical Trial
Authors: Charity C. Glass, MD, MPP
Robert M. Pride, MD
Rachel A. Freedman, MD, MPH
Erica L. Mayer, MD, MPH
Esther R. Ogayo, BS
Mariana Chavez-MacGregor, MD, MSc
Tari A. King, MD
Elizabeth A. Mittendorf, MD, PhD, MHCM
Olga Kantor, MD
Publication date: 05-09-2023
Publisher: Springer International Publishing
Keywords: Breast Cancer
Breast Cancer
Published in: Annals of Surgical Oncology / Issue 13/2023
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-023-14220-w

Keynote webinar | Spotlight on medication adherence

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Racial Disparities in Locoregional Recurrence in Postmenopausal Patients with Stage I–III, Hormone Receptor-Positive Breast Cancer Enrolled in the NSABP B-42 Clinical Trial

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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