Breast Cancer Characteristics and Survival in a Hispanic Population of Costa Rica

Abstract

BACKGROUNDBreast cancer characteristics may vary according to the patient’s ethnic group. The goal of this cohort study was to evaluate the characteristics of a group of Costa Rican breast cancer patients and their relationship with survival.METHODSAge, stage, tumor grade, immunohistochemistry, lymphovascular invasion, recurrence, and survival data on 199 Hispanic patients with breast cancer diagnosis, treated between January 2009 and May 2010, were collected from a single institution in San Jose, Costa Rica. The data were statistically analyzed for significance.RESULTSMedian age at diagnosis was 53 years. With a median follow-up of 46.5 months, there was an 88% overall survival rate. Thirty-seven percent of the patients (p < 0.001) were at stages III and IV during diagnosis. The hormone receptor human epidermal receptor negative phenotype (HR−HER2−) (p < 0.001) was present in 17% of the cases. In a multivariate analysis, local (risk ratio, RR: 7.2; confidence interval, CI 95%: 3.8–7.6; p = 0.06) and distant recurrence (RR: 14.9; CI 95%: 7.7–28.9; p = 0.01) showed the strongest association with the probability of death from the disease. Patients with HR−HER2− phenotype tumors reported more local recurrences (p = 0.04), a higher tumor grade (p < 0.01), and lower overall survival than patients with other breast cancer phenotypes (p = 0.01).CONCLUSIONSAlthough this study analyzes a modest number of cases, it is an initial insight into factors that may contribute to differences in breast cancer outcomes among Hispanic women in Costa Rica. The higher proportion of triple negative tumors, advanced stage, and younger median age at diagnosis could contribute to the inferior prognostic described among Hispanic women. There may be a different distribution of tumor subtypes compared to non-Hispanic white women. Further studies are necessary to confirm such findings.

Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer Is Associated with Indigenous American Ancestry in Latin American Women

“…The clinical characteristics of the Peruvian patients with breast cancer included in this study were similar to those described in other Latin American populations with young age and relatively high proportion of the most aggressive tumor subtypes (ER/PR À ; refs. 7,46,47). Furthermore, it reflects well the tumor characteristics of the overall patient population at INEN based on the similarities between our study patient characteristics and those included in a previously published review on INEN patient characteristics (48,49).…”

High prevalence of luminal B breast cancer intrinsic subtype in Colombian women

“…Previous studies in Hispanic/Latinas from the USA that analyzed the expression of markers such as hormone receptors and HER2 have shown that the most prevalent subtype is the luminal A (hormone receptor+/HER2−) followed by triple negative (31)(32)(33)(34). Our results are concordant with these studies as we found luminal A as the most frequent subtype (52.5%) followed by triple negative (20.6%), luminal B (16%) and HER2 (10.3) and unknown (0.6) when we group tumors by the expression of these three markers (ER, PgR and HER2).…”

Breast Cancer in Latinas: A Focus on Intrinsic Subtypes Distribution

“…Srur-Rivero et. al (69) analyzed 199 breast cancer patients from the San Juan de Dios Hospital in Costa Rica diagnosed between 2009 and 2010. This hospital is a reference cancer treatment center for Costa Rica’s South Central Region.…”