Impact of molecular subtype and race on HR+, HER2− breast cancer survival

Reid, Sonya; Haddad, Devin; Tezak, Ann; Weidner, Anne; Wang, Xuefeng; Mautz, Brian S.; Moore, Jared M.; Cadiz, Sydney; Zhu, Yuwei; Wang, Zheng; Mayer, Ingrid A.; Shu, Xiao‐Ou; Pal, Tuya

doi:10.1007/s10549-021-06342-0

Cited by 14 publications

(11 citation statements)

References 38 publications

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“…Studies that included molecular characterization of the tumor component beyond ER, PR and HER2 status suggest that survival disparities are restricted to specific subsets of HR+/HER2− tumors. Three studies that evaluated intrinsic subtypes in HR+/HER2− tumors found that Black women were significantly more likely to have tumors that were non-luminal A subtypes [18,34,35]. Importantly, while non-luminal A tumors were not associated with increased mortality in Black compared to White women, these tumors did have less favorable outcomes than the luminal A subtype [35].…”

Section: Discussionmentioning

confidence: 99%

“…Three studies that evaluated intrinsic subtypes in HR+/HER2− tumors found that Black women were significantly more likely to have tumors that were non-luminal A subtypes [18,34,35]. Importantly, while non-luminal A tumors were not associated with increased mortality in Black compared to White women, these tumors did have less favorable outcomes than the luminal A subtype [35]. The higher frequency of these tumors within Black women may be contributing to higher mortality.…”

Section: Discussionmentioning

confidence: 99%

“…The enrichment of more aggressive subtypes in Black women with HR+/HER2-breast cancer may contribute to the survival disadvantage. Within a group of 318 women with localized HR+/HER2-breast cancer, young Black women (47%) were more likely to have non-luminal A tumor subtypes than older Black (31%), young White (10%) and older White (30%) women [35]. While HR+/HER2− non-luminal A tumors were associated with higher 10-year mortality compared to HR+/HER2− luminal A tumors, 10-year survival did not differ significantly between Black and White women with the non-luminal A tumors (HR 1.23, 95% CI 0.58-2.58).…”

Section: Discordance Between Ihc Biomarkers and Intrinsic Subtypementioning

confidence: 99%

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Survival Disparities in US Black Compared to White Women with Hormone Receptor Positive-HER2 Negative Breast Cancer

Lovejoy

Shriver

Haricharan

et al. 2023

IJERPH

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Black women in the US have significantly higher breast cancer mortality than White women. Within biomarker-defined tumor subtypes, disparate outcomes seem to be limited to women with hormone receptor positive and HER2 negative (HR+/HER2−) breast cancer, a subtype usually associated with favorable prognosis. In this review, we present data from an array of studies that demonstrate significantly higher mortality in Black compared to White women with HR+/HER2-breast cancer and contrast these data to studies from integrated healthcare systems that failed to find survival differences. Then, we describe factors, both biological and non-biological, that may contribute to disparate survival in Black women.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discordance Between Ihc Biomarkers and Intrinsic Subtypementioning

confidence: 99%

See 1 more Smart Citation

Survival Disparities in US Black Compared to White Women with Hormone Receptor Positive-HER2 Negative Breast Cancer

Lovejoy

Shriver

Haricharan

et al. 2023

IJERPH

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“…Our results noted a significant difference between ethnicity and the proportion of Luminal A vs. Luminal B carcinoma. Luminal B tumors have more aggressive clinical and biological features with a lower expression of estrogen and progesterone receptors, making them less sensitive or effective for endocrine therapies compared to Luminal A tumors [ 30 ]. Incidence rates of Luminal A and Luminal B tumors and the association with age has been evaluated but a few studies have evaluated the rates of tumor Luminal subtypes (Luminal A or Luminal B) among racial groups [ 28 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

Association between Obesity, Race or Ethnicity, and Luminal Subtypes of Breast Cancer

Menikdiwela

Kahathuduwa

Bolner³

et al. 2022

Biomedicines

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Luminal breast cancers are the most common genomic subtype of breast cancers where Luminal A cancers have a better prognosis than Luminal B. Exposure to sex steroids and inflammatory status due to obesity are key contributors of Luminal tumor development. In this study, 1928 patients with Luminal A breast cancer and 1610 patients with Luminal B breast cancer were compared based on body mass index (BMI), age, race, menopausal status, and expressed receptors (i.e., estrogen (ER), progesterone (PR), and human epidermal growth factor receptor 2 (HER2)). Patients with Luminal B tumors had a significantly higher mean BMI (Δ = 0.69 kgm−2 [0.17, 1.21], p = 0.010) versus Luminal A. Interestingly, the risks of Luminal B tumors were higher among Black/African American patients versus White and Hispanic patients (p < 0.001 and p = 0.001, respectively). When controlled for each other, Black/African American race (p < 0.001) and increased BMI (p = 0.008) were associated with increased risks of Luminal B carcinoma, while postmenopausal status was associated with a decreased risk (p = 0.028). Increased BMI partially mediated the strong association between Black/African American race and the risk of Luminal B carcinoma. Thus, Black/African American race along with obesity seem to be associated with an increased risk of more aggressive Luminal B breast carcinomas.

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“…The three main tumor subtypes of BC, characterized by ER or PR expression and amplification of the ERBB2 gene, have different risk characteristics and treatment strategies, with the optimal treatment for each patient depending on the tumor subtype, anatomic tumor stage, and patient preference (11,(21)(22)(23)(24)(25). In addition, the role of genomic analyses such as detection of BRCA1 or BRCA2 germline mutations in treatment decisions has been shown to play an important role in clinical outcomes in BC (26)(27)(28)(29).…”

Section: Introductionmentioning

confidence: 99%

Smart Nanoparticles for Breast Cancer Treatment Based on the Tumor Microenvironment

et al. 2022

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Breast cancer (BC) is the most common malignant tumor in women. There are different risk characteristics and treatment strategies for different subtypes of BC. The tumor microenvironment (TME) is of great significance for understanding the occurrence, development, and metastasis of tumors. The TME plays an important role in all stages of BC metastasis, immune monitoring, immune response avoidance, and drug resistance, and also plays an important role in the diagnosis, prevention, and prognosis of BC. Smart nanosystems have broad development prospect in the regulation of the BC drug delivery based on the response of the TME. In particular, TME-responsive nanoparticles cleverly utilize the abnormal features of BC tissues and cells to achieve targeted transport, stable release, and improved efficacy. We here present a review of the mechanisms underlying the response of the TME to BC to provide potential nanostrategies for future BC treatment.

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Impact of molecular subtype and race on HR+, HER2− breast cancer survival

Cited by 14 publications

References 38 publications

Survival Disparities in US Black Compared to White Women with Hormone Receptor Positive-HER2 Negative Breast Cancer

Survival Disparities in US Black Compared to White Women with Hormone Receptor Positive-HER2 Negative Breast Cancer

Association between Obesity, Race or Ethnicity, and Luminal Subtypes of Breast Cancer

Smart Nanoparticles for Breast Cancer Treatment Based on the Tumor Microenvironment

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