Black women are more likely to die from breast cancer

Despite a slightly lower incidence rate of breast cancer than white women, black women diagnosed with breast cancer have a poorer prognosis, regardless of the disease subtype, according to a study presented at the recent virtual American Society of Clinical Oncology Annual Meeting.

In this exclusivity MedPage today video, author of the study Julia Blanter, MD, of Icahn’s Mount Sinai School of Medicine in New York City, discusses his summary.

Here is a transcript of his remarks:

Our goal was to examine whether there are differences in the risk of developing distant metastases after the initial diagnosis of breast cancer in black women compared to white women. Our project began as a follow-up to a previous NIH-funded cross-sectional study from 2013 to 2020 designed to examine whether insulin resistance mediated the association between race and breast cancer prognosis in black women and white self-identified with a new diagnosis of breast cancer.

We decided to look at this topic from the background research we were doing. We have found that black women diagnosed with breast cancer are more likely to have a poor prognosis regardless of the breast cancer subtype. And despite a lower breast cancer incidence rate than white women, black women have the highest breast cancer death rate of any racial and ethnic group, a feature often attributed to the late stage of diagnosis. and which has been under scrutiny for several decades. .

This was a retrospective study. We reviewed electronic medical records of 441 Mount Sinai Health System patients to assess metastases not present at initial diagnosis. We then performed univariate and multivariate analysis to determine whether black women had higher rates of distant metastases after diagnosis, and whether these still exist, taking into account factors such as age and stage.

What we found was that 6.9% of black women had distant metastases after diagnosis, while only 1.2% of white women had it. When performing multivariate analysis adjusted for age, race, and stage, black women were even more likely to have distant metastases after diagnosis, leading us to conclude that the disparities racial still exist in the development of distant metastasis, and this is independent from late diagnosis.

This study opened the door to many future projects, namely to find the source of the persistent disparity. In our study, we noted that black women had a shorter median follow-up time of 2.5 years, while white women had a median follow-up time of 3.1 years. These differences were statistically significant. However, we were unable to account for those who may have moved on to care outside of the Mount Sinai Health System and who may be followed at another facility.

I think it would be beneficial to take a closer look and see if there are any real differences in the tracking time. Additionally, we have not stratified our cases based on breast cancer subtype and treatment received, and hope to do so in a future study to see if it still exists. Namely, we found worrying that the disparity still exists despite many decades of research.

And we hope that by continuing to seek to understand why these bad results exist, we can begin to work on how to stop them.