Association of Race and Breast Cancer Stage. RESULTS

Posted by James

Five-thousand, seven-hundred-fifty-one patients (5,119 Caucasians, 632 African Americans) were eligible to be included in the study. There was no significant difference for menopausal status, topography, morphology and laterality of their breast cancers. African Americans were significantly younger, with a younger onset of menopause, less family history of breast cancer, fewer positive estrogen and progesterone receptors, more cigarette smokers, more Medicaid insured and more single and divorced individuals compared to Caucasians Americans (Table 1, p O.05). Multivariate analysis found no difference between the races for stage 0, stage 2 and stage 4 (Table 2). African Americans had significantly less stage-1 breast cancer (RR 0.80, 95% CI: 0.67-0.96), less combined stage 0 and 1 (RR 0.75, 95% CI: 0.63-0.89) and more combined stage-3 (RR 1.50 95% CI: 1.11-2.01).

Table 1. Univariate analysis—race and breast cancer stage

Variable                     Caucasians (N=5,119)

African Americans (N=632)

Odds Ratio*   P Value
Marital Status

O.01

Single 463 (9.0%)

119 (18.8%)

Married 3,344 (65.3%)

280 (44.3%)

Divorced 435 (8.5%)

119 (18.8%)

Widowed 877 (17.1%)

114 (18.0%)

Smoking

O.01

Nonsmoker 3,519 (68.7%)

373 (59.0%)

Cigarettes 968 (18.9%)

180 (28.5%)

Ex-smoker 632 (12.3%)

79 (12.5%)

Family Hx of Breast Cancer

0.78           0.02

Yes 1,124 (22.0%)

114 (18.0)

No 3,995 (78.0%)

518 (82.0%)

Estrogen Receptors

0.49          <0.01

Yes 2,831 (78.5%)

306 (64.3%)

No 774 (21.5%)

170 (35.7%)

Progesterone Receptors

0.58          <0.01

Yes 2,363 (65.5%)

247 (52.3%)

No 1,246 (34.5%)

225 (47.7%)

Medicaid

3.33          <0.01

Yes 126 (2.5%)

49 (7.8%)

No 4,993 (97.5%)

583 (92.2%)

Age 58.6 ± 13.5

56.4 ± 13.4

<0.01

Menopausal Age 46.0 ± 7.0

42.9 ± 7.2

<0.01

Topography

0.12

Axillary tail 13 (0.3%)

5 (0.8%)

Breast NOS, overlapping 2,298 (44.9%)

288 (45.6%)

Lower, inner quadrant 223 (4.4%)

31 (4.9%)

Lower, outer quadrant 303 (5.9%)

39 (6.2%)

Nipple 48 (0.9%)

1 (0.2%)

Upper, inner quad 384 (7.5%)

43 (6.8%)

Upper, outer quad 1,850 (36.1%)

225 (35.6%)

Morphology

0.07

Infiltrating ductal 3,533 (69.0%)

455 (72.0%)

Noninfiltrating intraductal 440 (8.6%)

36 (5.7%)

Lobular 272 (5.3%)

30 (4.7%)

Others 874 (17.1%)

111 (17.6%)

Laterality

0.32

Left 2,631 (51.4%)

338 (53.5%)

Right 2,488 (48.6%

294 (46.5%)

Menopausal Status

0.24

Premenopausal 1171 (22.9%)

154 (24.4%)

Perimenopausal 279 (5.5%)

32 (5.1%)

Postmenopausal 3,455 (67.5%)

410 (64.9%)

Unknown 214 (4.2%)

36 (5.7%)

* Odds of an African-American woman being positive compared to a Caucasian women

Table 2. Adjusted multivariate analysis*—race and breast cancer stage

AJCC Stage Odds Ratio** 95% CI P Value
0 0.15 (0.02-1.12) 0.06
1 0.80 (0.67-0.96) 0.02
0 and 1 0.75 (0.63-0.89) 0.001
2 1.16 (0.98-1.39) 0.09
3 1.50 (1.11-2.01) 0.01
4 0.98 (0.79-1.21) 0.85
* Controlling for family history, marital status, smoking, estrogen and progesterone receptors, insurance status, age, menopausal age;
** The odds of an African-American women being in each stage compared to a Caucasian women.

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