Table 1.
Studies evaluating the roles of race/ethnicity and socioeconomic status in breast cancer heterogeneity
| Author, journal, year | Study population | Study design, number of participants, and follow-up | Results |
|---|---|---|---|
| Auguste et al., PLoS One, 2017 | Women diagnosed with invasive breast cancer between 2003 and 2013 recorded by the Breast Cancer Registry in Côte-d’Or, France | Case-control study, n = 4,553 | No significant association was observed between SES and breast cancer molecular subtypes in French women. |
| Howlader et al., JNCI-J. Natl. Cancer Inst, 2014 | Women diagnosed with invasive breast cancer in 2010 from the 17 SEER registries in the US | Case-control study, n = 57,483 | Compared with non-Hispanic Whites, African Americans and Hispanics tended to develop triple-negative (African Americans: OR = 2.0, 95% CI = 1.8-2.2; Hispanics: OR = 1.3, 95% CI = 1.2-1.5) and ERBB2-enriched subtypes (African Americans: OR = 1.4, 95% CI = 1.2-1.6; Hispanics: OR = 1.4, 95% CI = 1.2-1.6) but not the luminal A subtype. Non-Hispanic Asian/Pacific Islanders tended to develop luminal B (OR = 1.2, 95% CI = 1.1 to 1.4) and ERBB2-enriched (OR = 1.8, 95% CI = 1.5-2.1) but less likely to develop triple-negative subtypes (OR = 0.8, 95% CI = 0.7-0.9) than the luminal A subtype. |
| Huo et al., JAMA Oncol, 2017 | Women diagnosed with invasive breast cancer and hosted in The Cancer Genome Atlas | Case-control study, n = 930 | Compared with non-Hispanic Whites, African Americans tended to develop triple-negative (OR = 3.80, 95% CI = 2.46-5.87) and ERBB2-enriched subtypes but not the luminal A subtype (OR = 2.22, 95% CI = 1.10-4.47). |
| Kong et al., JAMA Netw. Open, 2020 | Women diagnosed with invasive breast cancer between 2010 and 2015 from the 18 SEER registries in the US | Case-control study, n = 239,211 | Compared with non-Hispanic Whites, African Americans, Hispanics, and American Indian/Alaska Natives tended to develop luminal B (African Americans: OR = 1.28, 95% CI = 1.23-1.34; Hispanics: OR = 1.20, 95% CI = 1.15-1.25; American Indian/Alaska Natives: OR = 1.36, 95% CI = 1.16-1.59), ERBB2-enriched (African Americans: OR = 1.64, 95% CI = 1.55-1.74; Hispanics: OR = 1.41, 95% CI = 1.33-1.50; American Indian/Alaska Natives: OR = 1.47, 95% CI = 1.17-1.85), and triple-negative subtypes (African Americans: OR = 2.4, 95% CI = 2.31-2.48; Hispanics: OR = 1.28, 95% CI = 1.23-1.34; American Indian/Alaska Natives: OR = 1.26, 95% CI = 1.07-1.49) but not the luminal A subtype. Asian/Pacific Islander tended to develop luminal B (OR = 1.19, 95% CI = 1.14-1.25) and ERBB2-enriched (OR = 1.66, 1.56-1.76) but less likely to develop triple-negative subtypes (OR =0.91, 95% CI = 0.87-0.96) than the luminal A subtype. |
| Kulkarni et al., Cancer Health Disparities, 2019 | Women diagnosed with invasive breast cancer between 2008 and 2013 recorded by the New Jersey State Cancer Registry | Cohort study, n = 32,770 | Compared with non-Hispanic Whites, African Americans tended to have the worse overall survival with luminal A (HR = 1.64, 95% CI = 1.41-1.91), luminal B (HR = 1.54, 95% CI = 1.10-2.15), and triple-negative subtypes (HR = 1.28, 95% CI = 1.05-1.56). |
| Lawrenson et al., Cancer Causes Control, 2017 | Women diagnosed with stage I-III breast cancer between 2000 and 2013 recorded by the combined Waikato and Auckland Breast Cancer Registries in New Zealand | Cohort study, n = 9,015 | Compared with non-Māori/Pacific women, Māori and Pacific women with luminal A subtype tended to have the worse breast cancer-specific survival (HR = 1.52, 95% CI = 1.06-2.18; HR = 1.55, 95% CI = 1.04-2.31, respectively). |
| Linnenbringer et al., Breast Cancer Res Treat, 2020 | Non-Hispanic Whites and African Americans diagnosed with Triple-negative and luminal A subtypes between 2006 and 2014 recorded by the California Cancer Registry | Case-control study, n = 81,499 | Non-Hispanic Whites having higher neighborhood median household income were less likely to develop triple-negative subtypes than the luminal A subtype (OR = 0.99, 95% CI = 0.98-0.99). No significant association has been observed for African Americans. |
| Liu et al., Cancers, 2019 | Women aged ≥ 20 diagnosed with ductal carcinoma in situ from 1990 to 2015 with a median follow-up of 90 months from the 17 SEER registries in the US | Cohort study, n = 163,892, median follow-up = 90 months | Compared with non-Hispanic Whites, African Americans were more likely to develop triple-negative subtypes but not the luminal A subtype (HR = 1.99, 95% CI = 1.44-2.75). |
| Martínez et al., Breast Cancer Res Treat, 2017 | Non-Hispanic White and Hispanic female California residents aged ≥ 20 diagnosed with invasive breast cancer between 2004 and 2014 | Case-control study, n = 129,488 | Compared with non-Hispanic Whites, Hispanics tended to develop triple-negative (OR = 1.29, 95% CI = 1.23-1.35), ERBB2-enriched (OR = 1.19, 95% CI = 1.14-1.25), and luminal B subtypes (OR = 1.39, 95% CI = 1.31-1.48) but not the luminal A subtype. |
| Parise et al., Breast Cancer Res Treat, 2017 | Women diagnosed with Triple-negative and luminal A subtypes between 2000 and 2014 recorded by the California Cancer Registry | Case-control study, n = 108,372 | Non-Hispanic Whites and Hispanics having the lowest quintile of SES were more likely to develop triple-negative subtypes but not the luminal A subtype compared with those having the highest quintile of SES (OR = 1.15, 95% CI = 1.04-1.27; OR = 1.33, 95% CI = 1.05-1.68, respectively). No significant association has been observed for African Americans and Asian/Pacific Islander. |
| Parise et al., Cancer Epidemiol., 2014 | Women diagnosed with invasive breast cancer between 2000 and 2011 recorded by the California Cancer Registry | Case-control study, n = 225,441 | Compared with non-Hispanics Whites, Asian/Pacific Islanders tended to develop luminal B subtypes but not the luminal A subtype (OR = 1.17, 95% CI = 1.04-1.31). |
| Qin et al., Cancer Epidemiol. Biomarkers Prev, 2020 | African Americans diagnosed with invasive breast cancer between 2005 and 2017 in the Women’s Circle of Health and Women’s Circle of Health Follow-up Study | Case-control study, n = 1,220 | Compared with census tracts characterized by high-SES neighborhoods (T3), African Americans living in census tracts with intermediate- (T2) and low-SES neighborhoods (T1) tended to develop triple-negative subtypes but not the luminal A subtype (OR = 1.81, 95% CI = 1.20-2.71; OR = 1.95, 95% CI = 1.27-2.99, respectively; p-trend = 0.001). |
| Sineshaw et al., Breast Cancer Res Treat, 2014 | Women diagnosed with invasive breast cancer between 2010 and 2011 hosted in the National Cancer Data Base | Case-control study, n = 260,577 | Compared with non-Hispanics Whites, African Americans and Hispanics tended to develop triple-negative but not the luminal A subtype (African Americans: OR = 1.84, 95% CI = 1.77-1.92; Hispanics: OR = 1.17, 95% CI = 1.11-1.24). Non-Hispanic Asian/Pacific Islanders tended to develop ERBB2-enriched but not the luminal A subtype (OR = 1.45, 95% CI = 1.31-1.61). |
| Troester et al., JNCI-J. Natl. Cancer Inst, 2018 | African American and non-Hispanic White females diagnosed with invasive breast cancer from the Carolina Breast Cancer Study Phase 3 (2008-2013) | Case-control study, n = 980 | Compared with non-Hispanic Whites, African Americans tended to develop triple-negative but not the luminal A subtype (OR = 1.93, 95% CI = 1.27-2.93). |
| Zhao et al., Breast Cancer Res Treat, 2020 | African American and non-Hispanic White females diagnosed with invasive breast cancer between 1993 and 2019 at the University of Chicago Comprehensive Cancer Center | Cohort study, n = 2,795, median follow-up = 6.9 years | Compared with non-Hispanic Whites, African Americans with luminal A and ERBB2-enriched subtypes tended to have the worse overall survival (HR = 1.56, 95% CI = 1.22-2.00; HR = 1.26, 95% CI = 0.84-1.88, respectively), the worse recurrence-free survival (HR = 1.53, 95% CI = 1.22-1.91; HR = 3.00, 95% CI = 1.36-6.60, respectively), and the worse breast cancer-specific survival (HR = 2.37, 95% CI = 1.60-3.50; HR = 4.17, 95% CI = 1.35-12.88, respectively). African Americans with the luminal A subtype tended to have the worse time-to-recurrence survival (HR = 1.67, 95% CI = 1.20-2.34). |
Note: subtype definitions are as follows: luminal A = ERBB2 (HER2)-negative and [either ESR1 (ER)+ or PGR (PR)+]; luminal B = ERBB2+ and (either ESR1+ or PGR+); ERBB2-enriched = ERBB2+, ESR1-negative, PGR-negative; triple negative = ERBB2-negative, ESR1-negative, PGR-negative. We comply with standardized protein nomenclature recommended by an international expert panel40.
Abbreviation: CI, confidence interval; HR, hazard ratio; OR, odds ratio; SEER, Surveillance, Epidemiology, and End Results; SES, socioeconomic status.