Breast cancer molecular subtypes and survival in a hospital‐based sample in Puerto Rico

Ortiz, Ana P.; Frías, Orquídea; Pérez, Javier Martínez; Cabanillas, Fernando; Martínez, Lisa; Sánchez, Carola T.; Capó‐Ramos, David E.; González-Keelan, Carmen; Mora, Edna; Suárez, Erick

doi:10.1002/cam4.78

Cited by 19 publications

(21 citation statements)

References 54 publications

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“…At the time of initial diagnosis, the age (years) distribution varied significantly ( p -value < 0.05) by subtype; TNBC were the oldest (median 60 years), followed by Luminal A (median 58 years) and Luminal B (median 55 years) ( Table 1 ). This distribution of BC molecular subtypes is consistent with national U.S. statistics [ 6 , 7 , 19 , 20 , 21 ].…”

Section: Resultssupporting

confidence: 87%

Variability in DNA Repair Capacity Levels among Molecular Breast Cancer Subtypes: Triple Negative Breast Cancer Shows Lowest Repair

Matta

Ortíz

Encarnación

et al. 2017

IJMS

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Breast cancer (BC) is a heterogeneous disease which many studies have classified in at least four molecular subtypes: Luminal A, Luminal B, HER2-Enriched, and Basal-like (including triple-negative breast cancer, TNBC). These subtypes provide information to stratify patients for better prognostic predictions and treatment selection. Individuals vary in their sensitivities to carcinogens due to differences in their DNA repair capacity (DRC) levels. Although our previous case-control study established low DRC (in terms of NER pathway) as a BC risk factor, we aim to study this effect among the molecular subtypes. Therefore, the objectives of this study include investigating whether DRC varies among molecular subtypes and testing any association regarding DRC. This study comprised 267 recently diagnosed women with BC (cases) and 682 without BC (controls). Our results show a substantial variability in DRC among the molecular subtypes, with TNBC cases (n = 47) having the lowest DRC (p-value < 0.05). Almost 80 percent of BC cases had a DRC below the median (4.3%). Low DRC was strongly associated with the TNBC subtype (OR 7.2; 95% CI 3.3, 15.7). In conclusion, our study provides the first report on the variability among the molecular subtypes and provides a hypothesis based on DRC levels for the poor prognosis of TNBC.

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Section: Resultssupporting

confidence: 87%

Variability in DNA Repair Capacity Levels among Molecular Breast Cancer Subtypes: Triple Negative Breast Cancer Shows Lowest Repair

Matta

Ortíz

Encarnación

et al. 2017

IJMS

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“…This proportion (17.2–17.3%) has been reported for Hispanics in previous studies,16,10 which is higher than the one reported for Japanese patients (8%),17 but lower than for African-Americans (24.6–27.9%) 8,10. A higher proportion of HR−HER2− (23%) has also been described by Lara-Medina et al in Hispanic patients 6…”

Section: Discussionmentioning

confidence: 48%

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

Srur-Rivero

Cartín-Brenes

2014

Breast Cancer�(Auckl)

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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.

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“…However, only two studies have examined the patterns of breast cancer subtypes among Hispanic women [6,7]. Hines and colleagues assessed breast tumors of 69 Hispanic women [6], and found that the four most prevalent subtypes were ER+/PR+/HER2− (41%), triple negative (17%), ER−/PR−/HER2+ (15%) and ER+/PR+/HER2+ (13%).…”

Section: Introductionmentioning

confidence: 99%

“…Hines and colleagues assessed breast tumors of 69 Hispanic women [6], and found that the four most prevalent subtypes were ER+/PR+/HER2− (41%), triple negative (17%), ER−/PR−/HER2+ (15%) and ER+/PR+/HER2+ (13%). Ortiz et al showed a similar subtype distribution among 663 women with breast cancer in Puerto Rico, and reported a higher risk of death for triple negative and ER+/PR+/HER2+ tumors, compared to the ER+/PR+/HER2− subtype [7]. To expand on this work, data from the California Cancer Registry (CCR) on 16,380 Hispanic women diagnosed with invasive breast cancer were used to characterize the molecular subtypes defined by joint hormone receptor (HR) and HER2 status.…”

Section: Introductionmentioning

confidence: 99%

Heterogeneity of breast cancer subtypes and survival among Hispanic women with invasive breast cancer in California

Banegas

Altekruse

et al. 2014

Breast Cancer Res Treat

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Purpose There are limited data regarding breast cancer subtypes among Hispanic women. The current study assessed the distribution and prognosis of molecular subtypes defined by joint expression of the hormone receptors (HR; estrogen and progesterone) and human epidermal growth factor receptor 2 (HER2). Methods Using California Cancer Registry data, we identified Hispanic women diagnosed with invasive breast cancer from 2005–2010. Breast cancer subtypes were defined as HR+/HER2−, HR+/HER2+, HR−/HER2+, and HR−/HER2− (triple negative). We estimated breast cancer subtype frequencies and used polytomous logistic regression, Kaplan Meier survival plots and Cox regression to examine differences in relation to demographic and clinical characteristics. Results Among 16,380 Hispanic women with breast cancer, HR+/HER− subtype was most common (63%), followed by triple negative (16%), HR+/HER2+ (14%) and HR−/HER2+ (8%). Women in lower SES neighborhoods had greater risk of triple negative and HR−/HER2+ subtypes relative to HR+/HER2− (p<0.05). Hispanic women with triple negative and HR−/HER2+ tumors experienced poorer survival than those with HR+/HER− tumors. Breast cancer-specific mortality increased with decreasing SES, relative to the highest SES quintile, from HR=1.38 for quintile 4 to HR=1.76 for quintile 1 (lowest SES level). Conclusion Our findings indicate that Hispanic women residing in low SES neighborhoods had significantly increased risk of developing and dying from HR− than HR+ breast cancers. Similar patterns of subtype frequency and prognosis among California Hispanic women and studies of other racial/ethnic groups underscore the need to better understand the impact of SES on risk factor exposures that increase the risk of breast cancer subtypes with poor prognosis.

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Breast cancer molecular subtypes and survival in a hospital‐based sample in Puerto Rico

Cited by 19 publications

References 54 publications

Variability in DNA Repair Capacity Levels among Molecular Breast Cancer Subtypes: Triple Negative Breast Cancer Shows Lowest Repair

Variability in DNA Repair Capacity Levels among Molecular Breast Cancer Subtypes: Triple Negative Breast Cancer Shows Lowest Repair

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

Heterogeneity of breast cancer subtypes and survival among Hispanic women with invasive breast cancer in California

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