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Explaining Racial Differences in Breast Cancer Therapy Outcomes

July 06, 2022
breast cancer grandmother granddaughter

Black women diagnosed with breast cancer generally have worse outcomes than white women — a difference thought to result in part from Black women’s higher incidence of estrogen receptor (ER)–negative breast cancers, which often do not respond well to therapy. But after analyzing data from eight National Surgical Adjuvant Breast and Bowel Project (NSABP) trials involving more than 9,700 women with localized breast cancer, Maja H. Oktay, MD, PhD, and colleagues Jessica Pastoriza, MD, and Gina Kim, MD, found that the disparity was associated with ER-positive breast cancer — and, more specifically, with patients who have residual ER-positive disease following preoperative chemotherapy.

Maja H. Oktay, MD, PhD
Maja H. Oktay, MD, PhD

The researchers concluded that residual ER-positive breast cancer after preoperative chemotherapy is a risk factor for worse outcomes in Black women but not in white women, perhaps because of biological differences in how the tumor microenvironment responds to chemotherapy. Their paper was published online on May 17 in the journal Cancer.

Dr. Oktay is Professor of Pathology and a co-leader of the Tumor Microenvironment and Metastasis Program of the National Cancer Institute–designated Montefiore Einstein Cancer Center. She is also an attending physician at Montefiore Einstein.

Jessica Pastoriza, MD
Jessica Pastoriza, MD

Dr. Pastoriza is an Assistant Professor of Surgery and an attending physician at Montefiore Einstein. Dr. Kim is a resident in the Department of Surgery at Montefiore Einstein.

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