Originally published as JCO Early Release 10.1200/JCO.2008.17.9952 on December 1 2008

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Triple Receptor–Negative Breast Cancer: The Effect of Race on Response to Primary Systemic Treatment and Survival Outcomes

Shaheenah Dawood, Kristine Broglio, Shu-Wan Kau, Marjorie C. Green, Sharon H. Giordano, Funda Meric-Bernstam, Thomas A. Buchholz, Constance Albarracin, Wei T. Yang, Bryan T.J. Hennessy, Gabriel N. Hortobagyi, Ana Maria Gonzalez-Angulo

From the Departments of Breast Medical Oncology, Quantitative Sciences, Surgical Oncology, Radiation Oncology, Pathology, Diagnostic Imaging, and Gynecology Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX; and the Department of Medical Oncology, Dubai Hospital, Dubai, United Arab Emirates

Corresponding author: Shaheenah Dawood, MRCP, MPH, Department of Medical Oncology, Dubai Hospital, Department of Health and Medical Services, PO Box 8179, Dubai, United Arab Emirates; e-mail: Shaheenah_d{at}yahoo.com

Purpose The goal of this study was to describe the effect of race on pathologic complete response (pCR) rates and survival outcomes in women with triple receptor–negative (TN) breast cancers.

Patients and Methods Four hundred seventy-one patients with TN breast cancer diagnosed between 1996 and 2005 and treated with primary systemic chemotherapy were included. pCR was defined as no residual invasive cancer in the breast and axillary lymph nodes. Overall survival (OS) and recurrence-free survival (RFS) were estimated using the Kaplan-Meier product-limit method and compared between groups using the log-rank test. Cox proportional hazards models were fitted for each survival outcome to determine the relationship of patient and tumor variables with outcome.

Results Median follow-up time was 24.5 months. One hundred patients (21.2%) were black, and 371 patients (78.8%) were white/other race. Seventeen percent of black patients (n = 17) and 25.1% of white/other patients (n = 93) achieved a pCR (P = .091). Three-year RFS rates were 68% (95% CI, 56% to 76%) and 62% (95% CI, 57% to 67%) for black and white/other patients, respectively, with no significant difference observed between the two groups (P = .302). Three-year OS was similar for the two racial groups. After controlling for patient and tumor characteristics, race was not significantly associated with RFS (hazard ratio [HR] = 1.08; 95% CI, 0.69 to 1.68; P = .747) or OS (HR = 1.08; 95% CI, 0.69 to 1.68; P = .735) when white/other patients were compared with black patients.

Conclusion Race does not significantly affect pCR rates or survival outcomes in women with TN breast cancer treated in a single institution under the same treatment conditions.

published online ahead of print at www.jco.org on December 1, 2008

Supported in part by the Susan G. Komen Foundation and the Nellie B. Connally Fund for Breast Cancer Research; also supported by Grant No. K23CA121994-01 (A.M.G.-A.) from the National Cancer Institute and an American Society of Clinical Oncology Career Development Award (A.M.G.-A.).

Presented in part at the American Society of Clinical Oncology 2008 Breast Cancer Symposium, September 5-7, 2008, Washington, DC.

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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