African-American breast cancer patients who receive chemotherapy before surgery may experience lower rates of recurrence and higher survival rates than those who receive chemotherapy after surgery, according to a study
The study, “Distinctions in Breast Tumor Recurrence Patterns Post-Therapy among Racially Distinct Populations,” was published in PLOS One.
African-Americans have higher breast-cancer recurrence rates than European-Americans, the research showed. Researchers also found that African-Americans who receive neoadjuvant chemotherapy — or chemotherapy before tumor surgery — have lower rates of breast cancer recurring in lymph nodes or distant organs.
But African-Americans have higher rates of recurrence in the breasts themselves. A consolation for patients is that recurrence in the breasts is easier to manage and associated with better prognosis, or the course the disease follows.
The rate of breast cancer occurring is similar between African-Americans and European-Americans. But African-Americans’ cancer is more aggressive, and the date rate of premenopausal and menopausal African-Americans is 40 percent higher than among European-Americans. Such disparities have been a challenge for clinicians.
Studies have suggested that African-Americans’ higher risk of breast-cancer recurrence may associated with the differences in the groups’ disease outcomes. But neither the differences in recurrence rates, nor their association with treatment patterns, had been thoroughly evaluated.
To address that, researchers assessed 10,504 breast cancer patients treated at the Northside Hospital in Atlanta from 2005 to 2015. Among them, 225 patients — 166 European-Americans and 49 African-Americans — had experienced a recurrence.
Researchers discovered that African-American patients were 70 percent more likely to have a recurrence than European-Americans, regardless of treatment setting.
“We found that, in general, African-American breast cancer patients exhibit increased likelihood for tumor recurrence, particularly to regional and distant sites, after receiving any combination of adjuvant therapy (treatment following surgery) compared to European-American breast cancer patients. This higher incidence of tumor recurrence can contribute to a poorer prognosis,” Nikita Wright, first author of the study, said in a press release.
Wright, a senior PhD student in Dr. Ritu Aneja’s laboratory at Georgia State University’s Biology Department, said local recurrence — or cancer returning to the breast — is easier to treat than the cancer returning to lymph nodes — regional recurrence — or distant organs — distant recurrence.
“Interestingly, we found that neoadjuvant chemotherapy actually reversed these recurrence trends,” Wright said. “We found that African-American breast cancer patients responded better to neoadjuvant chemotherapy than European-American patients. Among patients who received neoadjuvant chemotherapy, African-Americans exhibited trends of lower regional and distant tumor recurrence than European-Americans, but higher local recurrence, which is easier to manage clinically and is associated with a relatively better prognosis.”
Together, the findings showed that neoadjuvant chemotherapy may improve the prognosis and survival rates of African-Americans.