Nhim Vutha, Bencomo-Alvarez Alfonso E, Alvarado Luis, Kilcoyne Michelle, Gonzalez-Henry Mayra A, Olivas Idaly M, Keivan Mehrshad, Gaur Sumit, Mulla Zuber D, Dwivedi Alok K, Gadad Shrikanth S, Eiring Anna M
Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, United States.
University of Arkansas for Medical Sciences, Washington Regional Medical Center, Fayetteville, AR, United States.
Front Oncol. 2024 Aug 16;14:1443399. doi: 10.3389/fonc.2024.1443399. eCollection 2024.
Breast cancer (BC) affects racial and ethnic groups differently, leading to disparities in clinical presentation and outcomes. It is unclear how Hispanic ethnicity affects BC outcomes based on geographic location and proximity to the United States (U.S.)/Mexico border. We hypothesized that the impact of race/ethnicity on BC outcomes depends on geographic location and country of origin within each BC subtype.
We analyzed BC data from the Texas Cancer Registry by race/ethnicity/birthplace according to BC subtype (luminal A/luminal B/human epidermal growth factor receptor 2 [HER2]/triple-negative breast cancer[TNBC]). Other covariates included age, geographic location (U.S., Mexico), residency (border, non-border), treatments, and comorbidities. Crude and adjusted effects of race/ethnicity and birthplace on overall survival (OS) were analyzed using Cox regression methods.
Our analysis of 76,310 patient records with specific BC subtypes revealed that Hispanic and non-Hispanic Black (NHB) patients were diagnosed at a younger age compared with non-Hispanic White (NHW) patients for all BC subtypes. For the 19,748 BC patients with complete data on race/ethnicity/birthplace/residency, Hispanic patients had a higher mortality risk in the Luminal A subtype, regardless of birthplace, whereas U.S.-born Hispanics had a higher risk of death in the TNBC subtype. In contrast, NHB patients had a higher mortality risk in the Luminal A and HER2 subtypes. Residence along the U.S./Mexico border had little impact on OS, with better outcomes in Luminal A patients and worse outcomes in Luminal B patients aged 60-74 years.
Race/ethnicity, geographic birth location, and residency were significant predictors of survival in BC. Migration, acculturation, and reduced healthcare access may contribute to outcome differences.
乳腺癌（BC）对不同种族和族裔群体的影响不同，导致临床表现和治疗结果存在差异。目前尚不清楚西班牙裔种族如何根据地理位置以及与美国/墨西哥边境的距离影响乳腺癌的治疗结果。我们假设种族/族裔对乳腺癌治疗结果的影响取决于地理位置和每种乳腺癌亚型内的原籍国。
我们根据乳腺癌亚型（腔面A型/腔面B型/人表皮生长因子受体2[HER2]/三阴性乳腺癌[TNBC]），按种族/族裔/出生地分析了德克萨斯癌症登记处的乳腺癌数据。其他协变量包括年龄、地理位置（美国、墨西哥）、居住地（边境、非边境）、治疗方法和合并症。使用Cox回归方法分析种族/族裔和出生地对总生存期（OS）的粗效应和调整效应。
我们对76310例具有特定乳腺癌亚型的患者记录进行分析后发现，所有乳腺癌亚型中，西班牙裔和非西班牙裔黑人（NHB）患者的诊断年龄均比非西班牙裔白人（NHW）患者小。对于19748例有完整种族/族裔/出生地/居住地数据的乳腺癌患者，无论出生地如何，西班牙裔患者在腔面A型亚型中的死亡风险较高，而在美国出生的西班牙裔患者在三阴性乳腺癌亚型中的死亡风险较高。相比之下，非西班牙裔黑人患者在腔面A型和HER2亚型中的死亡风险较高。居住在美国/墨西哥边境对总生存期影响不大，腔面A型患者的治疗结果较好，而60 - 74岁的腔面B型患者的治疗结果较差。
种族/族裔、地理出生地和居住地是乳腺癌生存的重要预测因素。移民、文化适应和医疗保健机会减少可能导致治疗结果存在差异。
