S. Ullrich2, R. Kaur2, J. Parks1, L. Dresner1, A. Alfonso1, G. Sugiyama1 1SUNY Downstate Medical Center,Surgery,Brooklyn, NY – NEW YORK, USA 2SUNY Downstate College Of Medicine,Brooklyn, NY – NEW YORK, USA
Introduction: Disparity in the diagnosis, treatment, and outcome for women with Breast Cancer across ethnic and socioeconomic groups is growing in the United States. Black and Hispanic women present at higher stages and are twice as likely to die from the disease. Disparity has persisted despite improvement in access and quality of care. By identifying population based differences in tumor biology, we can tailor screening so that more effective, tumor specific treatment protocols can be designed. At our urban academic medical center, we treat a unique subset of the low-income Black population, 90.6% of whom are Caribbean-born. We hypothesize that Caribbean American Black patients treated at our urban medical center present with more aggressive disease that is biologically distinct from the Black population across the United States
Methods: Data was obtained by retrospective chart review of all patients who underwent biopsy, lumpectomy, partial mastectomy or modified radical mastectomy at our academic medical center from 2007 through 2012. Average age at presentation, stage at presentation and tumor receptor characteristics were calculated and stratified by race and ethnicity, then compared with data from the Neighborhood and Breast Cancer (NABC) study and the California Cancer Registry (CCR).
Results: We identified 235 patients who underwent biopsy, lumpectomy, partial mastectomy or modified radical mastectomy for in situ or invasive breast carcinoma. Caribbean-American Black patients at our urban medical center presented at older ages than Black patients throughout the country and were more likely to present with more advanced disease (19.33% vs 8% presented at AJCC Stage III). Caribbean-American Black patients were also more than twice as likely to present with the Hormone Receptor negative Her2 positive subtype of invasive carcinoma than their African-American counterparts (17% vs 8%).
Conclusion: Caribbean-American Black patients who received surgical treatment for breast cancer at our academic medical center presented with more advanced disease. In contrast with what has been shown in the literature, minority patients in our community do not present at an early age. In addition, the Caribbean-American Black population at our Central Brooklyn medical center also has a distinct pattern of receptor subtypes. This suggests that the underlying tumor biology of Caribbean-American Black patients is different from other Black patients, and that further investigation is necessary to tailor the therapy for our patient population.
