K. A. Dookeran

Race and the influence of p53 as a marker of prognosis in women of lower SES with breast cancer.

10590 Background: We previously identified p53 as an independent marker of prognosis in African-American (AA) women with breast cancer. However, it is unclear whether the influence of p53 is unique to AA women or is present in other race/ethnicity groups. We evaluated whether prognostic profiles differ between AA and non-AA women of lower socioeconomic status (SES) with breast cancer. Methods: Proportional hazards regression models [hazard ratios (HR), 95% confidence intervals (CIs)] were used to select and evaluate factors prognostic for all-cause mortality (age, stage, grade, ERPR status, subtype, p53 status), in 331 AA and 203 non-AA [115 Hispanic, 88 non-Hispanic white] women, treated consecutively at an urban hospital (44 months median follow-up), with known intrinsic subtype and p53 immunohistochemical status. Results: Significant baseline prognostic factors were, for AA women: stage [HR, 2.28; 95% CI, 1.86–2.79; p<0.001], grade [HR, 1.55; 95% CI, 1.14–2.11; p=0.005], ERPR status [HR, 0.49; 95% CI, ...

p53 as an additional marker to the intrinsic subtype classification as a method to further stratify breast cancer survival in African American (AA) women

22007 Background: We hypothesized that breast cancer survival using the intrinsic subtype classification (i.e. luminal A/B type [A=ER+, &/or PR+, & HER2−; B=ER+, &/or PR+, & HER2+], HER2+ type [ER−...

African-American women with breast cancer treated with preoperative chemotherapy have reduced pathologic complete response rates

876 Background: African-American (AA) women with breast cancer have an increased risk of death, compared with white women. Biologic differences may contribute to outcome disparities for AA women. Response to preoperative (preop) chemotherapy in AA women may provide useful information on tumor biology.nnnMETHODSnWe retrospectively reviewed 442 consecutive minority-underserved women treated for breast cancer at the MBCCOP, Stroger Hospital of Cook County, in Chicago.nnnRESULTSnPreop therapy was given to 63 (23%) women and 42 had records for review. Of these, 50% (21) were AA. Preop clinical stage distribution for AAs showed 1 with 2A, 5 with 2B, 12 with 3A and 3 with 3B disease; for non-AAs the distribution was 1 with 2A, 8 with 2B, 4 with 3A and 7 with 3B disease. Although more AAs had 3B disease and more non-AAs had 2B disease, this was not significant. Preop node positive status was 17 AAs vs. 14 non-AAs. AC only was used almost equally for both groups (6 AA vs. 7 non-AA), and the addition of Taxane was similar (15 AA vs. 13 non-AA). Equal numbers from both groups were non-compliant with preop therapy (2 AA & 2 non-AA), or had disease progression (2 AA & 2 non-AA). Pathologic residual invasive disease was found in 91% AAs and 76% non-AAs. Pathologic microscopic invasive disease was found in 10% AAs and 5% non-AAs. Pathologic complete response (pCR) was not found in AAs, but 19% non-AAs had a pCR. Node positive status post surgery was similar for both groups (N1: 4 AA vs. 3 non-AA; N2: 7 AA vs. 8 non-AA). For non-AAs, 3 of 4 pCRs occurred in patients with preop clinical stage 3B, and 1 in stage 2B; in this group, pathologic down staging was seen in 63% of 2B, 50% of 3A, & 72% of 3B disease. For AA women, pathologic down staging was comparable, with 60% of 2B, 67% of 3A, & 100% of 3B disease, but pCR did not occur.nnnCONCLUSIONSnThese results indicate that AA women with breast cancer treated with preop therapy have reduced pCR rates compared to non-AAs. It is unlikely that these results are due to differences in stage distribution, type of therapy or compliance issues. Further investigation of potential differences in tumor biology is required. [Table: see text].