Molecular subtypes of triple-negative breast cancer in women of different race and ethnicity
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Yuan Chun Ding1, Linda Steele1, Charles Warden2, Sharon Wilczynski3, Joanne Mortimer4, Yuan Yuan4 and Susan L. Neuhausen1
1Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, CA, USA
2Department of Cellular and Molecular Biology, Beckman Research Institute of City of Hope, Duarte, CA, USA
3Department of Pathology, City of Hope, Duarte, CA, USA
4Department of Medical Oncology, City of Hope, Duarte, CA, USA
Susan L. Neuhausen, email: firstname.lastname@example.org
Keywords: triple-negative breast cancer; molecular subtypes; hispanics; asians; african-Americans
Received: September 21, 2018 Accepted: December 27, 2018 Published: January 04, 2019
Molecular subtypes of triple negative breast cancer (TNBC) are associated with variation in survival and may assist in treatment selection. However, the association of patient race or ethnicity with subtypes of TNBC and clinical outcome has not been addressed. Using nCounter Gene Expression Codesets, we classified TNBCs into subtypes: basal-like immune-activated (BLIA), basal-like immunosuppressed (BLIS), luminal androgen receptor (LAR), and mesenchymal (MES) in 48 Hispanic, 12 African-American, 21 Asian, and 34 White patients. Mean age at diagnosis was significantly associated with subtype, with the youngest mean age (50 years) in MES and the oldest mean age (64 years) in LAR (p < 0.0005). Subtype was significantly associated with tumor grade (p = 0.0012) and positive lymph nodes (p = 0.021), with a marginally significant association of tumor stage (p = 0.076). In multivariate Cox-proportional hazards modeling, BLIS was associated with worst survival and LAR with best survival. Hispanics had a significantly higher proportion of BLIS (53%, p = 0.03), whereas Asians had a lower proportion of BLIS (19%, p = 0.05) and a higher proportion of LAR (38%, p = 0.06) compared to the average proportion across all groups. These differences in proportions of subtype across racial and ethnic groups may explain differences in their outcomes. Determining subtypes of TNBC facilitates understanding of the heterogeneity of the TNBCs and provides a foundation for developing subtype-specific therapies and better predictors of TNBC prognosis for all races and ethnicities.
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