Genomic expression assay testing among American Indian and Alaska Native women with breast cancer
Background Breast cancer is one of the most common causes of cancer mortality for all women, including American Indian and Alaska Native (AI/AN) women. The use of the 21‐gene recurrence score (RS) appears to be predictive of the benefit of chemotherapy for women with estrogen receptor (ER)–positive...
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| creator | Marmor, Schelomo Longacre, Colleen F. Altman, Ariella M. Hui, Jane Y. C. Jensen, Eric H. Tuttle, Todd M. |
| description | Background
Breast cancer is one of the most common causes of cancer mortality for all women, including American Indian and Alaska Native (AI/AN) women. The use of the 21‐gene recurrence score (RS) appears to be predictive of the benefit of chemotherapy for women with estrogen receptor (ER)–positive breast cancer. The objective of the current study was to compare RS testing between AI/AN and non‐Hispanic White (NHW) women with breast cancer.
Methods
The Surveillance, Epidemiology, and End Results program was used to identify women with ER‐positive breast cancer from 2004 through 2015. Multivariable logistic regression was used to evaluate factors associated with RS use, with high‐risk RS, and with chemotherapy use among those with a high‐risk RS.
Results
A total of 363,387 NHW patients and 1951 AI/AN patients with ER‐positive breast cancer were identified. AI/AN women were found to be less likely to undergo RS testing and, when tested, were more likely to have a high‐risk RS. In the multivariable logistic regression analysis, AI/AN women were found to be significantly more likely to have a high‐risk RS (odds ratio,1.28; 95% confidence interval, 1.01‐1.66). Among untested women, chemotherapy use was higher for AI/AN women; however, the use of chemotherapy was not found to be significantly different between the groups with a high‐risk RS. Using Cox proportional hazards models, AI/AN race was found to be significantly associated with worse overall survival.
Conclusions
AI/AN women were less likely to undergo RS testing compared with NHW women and were more likely to have a high‐risk RS. Reversing the disparity in genomic expression assay testing is critical to ensure guideline‐based breast cancer treatment and improve survival rates for AI/AN women with breast cancer.
Compared with non‐Hispanic White (NHW) women, American Indian and Alaska Native (AI/AN) women with estrogen receptor—positive breast cancer appear to be less likely to undergo genomic expression assay testing. Among tested women, AI/AN patients with breast cancer are more likely to have high‐risk recurrence scores compared with NHW women. |
| doi_str_mv | 10.1002/cncr.33150 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2442840707</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2442840707</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3930-fb31412598b05c8838a569ebc8ac7a09ee30de0a79132213b7b0c6b28dedee263</originalsourceid><addsrcrecordid>eNp90EtLAzEUBeAgiq3VjT9AAm5EGL1J5rksxReIgii4G-5kbjU6k6nJ1Np_b7TVhQs3uQQ-DofD2L6AEwEgT7XV7kQpkcAGGwoosghELDfZEADyKInV44DteP8SvplM1DYbKFnINFbJkOEF2a41mtPHzJH3prMcvccl78n3xj5xbLvwjltyRqPlV7Y24aCt-bhB_4r8BnvzTnzRtWT5wvTPvHKEvueBa3K7bGuKjae99R2xh_Oz-8lldH17cTUZX0daFQqiaaVELGRS5BUkOs9VjklaUKVz1BlCQaSgJsCsEEpKoaqsAp1WMq-pJpKpGrGjVe7MdW_zUL5sjdfUNGipm_tSxrHMY8ggC_TwD33p5s6GdkGlKsliFTqN2PFKadd572hazpxp0S1LAeXX8OXX8OX38AEfrCPnVUv1L_1ZOgCxAgvT0PKfqHJyM7lbhX4Co5aNTA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2463574339</pqid></control><display><type>article</type><title>Genomic expression assay testing among American Indian and Alaska Native women with breast cancer</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Wiley Free Content</source><source>Wiley Online Library All Journals</source><source>Alma/SFX Local Collection</source><creator>Marmor, Schelomo ; Longacre, Colleen F. ; Altman, Ariella M. ; Hui, Jane Y. C. ; Jensen, Eric H. ; Tuttle, Todd M.</creator><creatorcontrib>Marmor, Schelomo ; Longacre, Colleen F. ; Altman, Ariella M. ; Hui, Jane Y. C. ; Jensen, Eric H. ; Tuttle, Todd M.</creatorcontrib><description>Background
Breast cancer is one of the most common causes of cancer mortality for all women, including American Indian and Alaska Native (AI/AN) women. The use of the 21‐gene recurrence score (RS) appears to be predictive of the benefit of chemotherapy for women with estrogen receptor (ER)–positive breast cancer. The objective of the current study was to compare RS testing between AI/AN and non‐Hispanic White (NHW) women with breast cancer.
Methods
The Surveillance, Epidemiology, and End Results program was used to identify women with ER‐positive breast cancer from 2004 through 2015. Multivariable logistic regression was used to evaluate factors associated with RS use, with high‐risk RS, and with chemotherapy use among those with a high‐risk RS.
Results
A total of 363,387 NHW patients and 1951 AI/AN patients with ER‐positive breast cancer were identified. AI/AN women were found to be less likely to undergo RS testing and, when tested, were more likely to have a high‐risk RS. In the multivariable logistic regression analysis, AI/AN women were found to be significantly more likely to have a high‐risk RS (odds ratio,1.28; 95% confidence interval, 1.01‐1.66). Among untested women, chemotherapy use was higher for AI/AN women; however, the use of chemotherapy was not found to be significantly different between the groups with a high‐risk RS. Using Cox proportional hazards models, AI/AN race was found to be significantly associated with worse overall survival.
Conclusions
AI/AN women were less likely to undergo RS testing compared with NHW women and were more likely to have a high‐risk RS. Reversing the disparity in genomic expression assay testing is critical to ensure guideline‐based breast cancer treatment and improve survival rates for AI/AN women with breast cancer.
Compared with non‐Hispanic White (NHW) women, American Indian and Alaska Native (AI/AN) women with estrogen receptor—positive breast cancer appear to be less likely to undergo genomic expression assay testing. Among tested women, AI/AN patients with breast cancer are more likely to have high‐risk recurrence scores compared with NHW women.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/cncr.33150</identifier><identifier>PMID: 32926435</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>21‐gene recurrence score ; Adult ; Aged ; Alaska Native ; Alaska Natives - genetics ; American Indian ; Biomarkers, Tumor - genetics ; Breast cancer ; Breast Neoplasms - drug therapy ; Breast Neoplasms - genetics ; Chemotherapy ; Chemotherapy, Adjuvant - methods ; Confidence intervals ; Epidemiology ; Estrogen receptors ; Estrogens ; Female ; Gene expression ; Gene Expression Profiling - methods ; Gene Expression Regulation, Neoplastic - drug effects ; genomic expression assays ; Humans ; Indians, North American - genetics ; Logistic Models ; Mastectomy ; Middle Aged ; Oncology ; Practice Guidelines as Topic ; racial disparities ; Regression analysis ; Risk ; SEER Program ; Statistical analysis ; Statistical models ; Survival ; Survival Analysis ; Treatment Outcome ; Young Adult</subject><ispartof>Cancer, 2020-12, Vol.126 (24), p.5222-5229</ispartof><rights>2020 American Cancer Society</rights><rights>2020 American Cancer Society.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3930-fb31412598b05c8838a569ebc8ac7a09ee30de0a79132213b7b0c6b28dedee263</citedby><cites>FETCH-LOGICAL-c3930-fb31412598b05c8838a569ebc8ac7a09ee30de0a79132213b7b0c6b28dedee263</cites><orcidid>0000-0003-0880-2721 ; 0000-0001-6603-2062 ; 0000-0002-2628-0720 ; 0000-0003-4191-0679 ; 0000-0002-5484-5004</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fcncr.33150$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fcncr.33150$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,1432,27923,27924,45573,45574,46408,46832</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32926435$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Marmor, Schelomo</creatorcontrib><creatorcontrib>Longacre, Colleen F.</creatorcontrib><creatorcontrib>Altman, Ariella M.</creatorcontrib><creatorcontrib>Hui, Jane Y. C.</creatorcontrib><creatorcontrib>Jensen, Eric H.</creatorcontrib><creatorcontrib>Tuttle, Todd M.</creatorcontrib><title>Genomic expression assay testing among American Indian and Alaska Native women with breast cancer</title><title>Cancer</title><addtitle>Cancer</addtitle><description>Background
Breast cancer is one of the most common causes of cancer mortality for all women, including American Indian and Alaska Native (AI/AN) women. The use of the 21‐gene recurrence score (RS) appears to be predictive of the benefit of chemotherapy for women with estrogen receptor (ER)–positive breast cancer. The objective of the current study was to compare RS testing between AI/AN and non‐Hispanic White (NHW) women with breast cancer.
Methods
The Surveillance, Epidemiology, and End Results program was used to identify women with ER‐positive breast cancer from 2004 through 2015. Multivariable logistic regression was used to evaluate factors associated with RS use, with high‐risk RS, and with chemotherapy use among those with a high‐risk RS.
Results
A total of 363,387 NHW patients and 1951 AI/AN patients with ER‐positive breast cancer were identified. AI/AN women were found to be less likely to undergo RS testing and, when tested, were more likely to have a high‐risk RS. In the multivariable logistic regression analysis, AI/AN women were found to be significantly more likely to have a high‐risk RS (odds ratio,1.28; 95% confidence interval, 1.01‐1.66). Among untested women, chemotherapy use was higher for AI/AN women; however, the use of chemotherapy was not found to be significantly different between the groups with a high‐risk RS. Using Cox proportional hazards models, AI/AN race was found to be significantly associated with worse overall survival.
Conclusions
AI/AN women were less likely to undergo RS testing compared with NHW women and were more likely to have a high‐risk RS. Reversing the disparity in genomic expression assay testing is critical to ensure guideline‐based breast cancer treatment and improve survival rates for AI/AN women with breast cancer.
Compared with non‐Hispanic White (NHW) women, American Indian and Alaska Native (AI/AN) women with estrogen receptor—positive breast cancer appear to be less likely to undergo genomic expression assay testing. Among tested women, AI/AN patients with breast cancer are more likely to have high‐risk recurrence scores compared with NHW women.</description><subject>21‐gene recurrence score</subject><subject>Adult</subject><subject>Aged</subject><subject>Alaska Native</subject><subject>Alaska Natives - genetics</subject><subject>American Indian</subject><subject>Biomarkers, Tumor - genetics</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - drug therapy</subject><subject>Breast Neoplasms - genetics</subject><subject>Chemotherapy</subject><subject>Chemotherapy, Adjuvant - methods</subject><subject>Confidence intervals</subject><subject>Epidemiology</subject><subject>Estrogen receptors</subject><subject>Estrogens</subject><subject>Female</subject><subject>Gene expression</subject><subject>Gene Expression Profiling - methods</subject><subject>Gene Expression Regulation, Neoplastic - drug effects</subject><subject>genomic expression assays</subject><subject>Humans</subject><subject>Indians, North American - genetics</subject><subject>Logistic Models</subject><subject>Mastectomy</subject><subject>Middle Aged</subject><subject>Oncology</subject><subject>Practice Guidelines as Topic</subject><subject>racial disparities</subject><subject>Regression analysis</subject><subject>Risk</subject><subject>SEER Program</subject><subject>Statistical analysis</subject><subject>Statistical models</subject><subject>Survival</subject><subject>Survival Analysis</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90EtLAzEUBeAgiq3VjT9AAm5EGL1J5rksxReIgii4G-5kbjU6k6nJ1Np_b7TVhQs3uQQ-DofD2L6AEwEgT7XV7kQpkcAGGwoosghELDfZEADyKInV44DteP8SvplM1DYbKFnINFbJkOEF2a41mtPHzJH3prMcvccl78n3xj5xbLvwjltyRqPlV7Y24aCt-bhB_4r8BnvzTnzRtWT5wvTPvHKEvueBa3K7bGuKjae99R2xh_Oz-8lldH17cTUZX0daFQqiaaVELGRS5BUkOs9VjklaUKVz1BlCQaSgJsCsEEpKoaqsAp1WMq-pJpKpGrGjVe7MdW_zUL5sjdfUNGipm_tSxrHMY8ggC_TwD33p5s6GdkGlKsliFTqN2PFKadd572hazpxp0S1LAeXX8OXX8OX38AEfrCPnVUv1L_1ZOgCxAgvT0PKfqHJyM7lbhX4Co5aNTA</recordid><startdate>20201215</startdate><enddate>20201215</enddate><creator>Marmor, Schelomo</creator><creator>Longacre, Colleen F.</creator><creator>Altman, Ariella M.</creator><creator>Hui, Jane Y. C.</creator><creator>Jensen, Eric H.</creator><creator>Tuttle, Todd M.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TO</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0880-2721</orcidid><orcidid>https://orcid.org/0000-0001-6603-2062</orcidid><orcidid>https://orcid.org/0000-0002-2628-0720</orcidid><orcidid>https://orcid.org/0000-0003-4191-0679</orcidid><orcidid>https://orcid.org/0000-0002-5484-5004</orcidid></search><sort><creationdate>20201215</creationdate><title>Genomic expression assay testing among American Indian and Alaska Native women with breast cancer</title><author>Marmor, Schelomo ; Longacre, Colleen F. ; Altman, Ariella M. ; Hui, Jane Y. C. ; Jensen, Eric H. ; Tuttle, Todd M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3930-fb31412598b05c8838a569ebc8ac7a09ee30de0a79132213b7b0c6b28dedee263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>21‐gene recurrence score</topic><topic>Adult</topic><topic>Aged</topic><topic>Alaska Native</topic><topic>Alaska Natives - genetics</topic><topic>American Indian</topic><topic>Biomarkers, Tumor - genetics</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - drug therapy</topic><topic>Breast Neoplasms - genetics</topic><topic>Chemotherapy</topic><topic>Chemotherapy, Adjuvant - methods</topic><topic>Confidence intervals</topic><topic>Epidemiology</topic><topic>Estrogen receptors</topic><topic>Estrogens</topic><topic>Female</topic><topic>Gene expression</topic><topic>Gene Expression Profiling - methods</topic><topic>Gene Expression Regulation, Neoplastic - drug effects</topic><topic>genomic expression assays</topic><topic>Humans</topic><topic>Indians, North American - genetics</topic><topic>Logistic Models</topic><topic>Mastectomy</topic><topic>Middle Aged</topic><topic>Oncology</topic><topic>Practice Guidelines as Topic</topic><topic>racial disparities</topic><topic>Regression analysis</topic><topic>Risk</topic><topic>SEER Program</topic><topic>Statistical analysis</topic><topic>Statistical models</topic><topic>Survival</topic><topic>Survival Analysis</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Marmor, Schelomo</creatorcontrib><creatorcontrib>Longacre, Colleen F.</creatorcontrib><creatorcontrib>Altman, Ariella M.</creatorcontrib><creatorcontrib>Hui, Jane Y. C.</creatorcontrib><creatorcontrib>Jensen, Eric H.</creatorcontrib><creatorcontrib>Tuttle, Todd M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Marmor, Schelomo</au><au>Longacre, Colleen F.</au><au>Altman, Ariella M.</au><au>Hui, Jane Y. C.</au><au>Jensen, Eric H.</au><au>Tuttle, Todd M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Genomic expression assay testing among American Indian and Alaska Native women with breast cancer</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2020-12-15</date><risdate>2020</risdate><volume>126</volume><issue>24</issue><spage>5222</spage><epage>5229</epage><pages>5222-5229</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><abstract>Background
Breast cancer is one of the most common causes of cancer mortality for all women, including American Indian and Alaska Native (AI/AN) women. The use of the 21‐gene recurrence score (RS) appears to be predictive of the benefit of chemotherapy for women with estrogen receptor (ER)–positive breast cancer. The objective of the current study was to compare RS testing between AI/AN and non‐Hispanic White (NHW) women with breast cancer.
Methods
The Surveillance, Epidemiology, and End Results program was used to identify women with ER‐positive breast cancer from 2004 through 2015. Multivariable logistic regression was used to evaluate factors associated with RS use, with high‐risk RS, and with chemotherapy use among those with a high‐risk RS.
Results
A total of 363,387 NHW patients and 1951 AI/AN patients with ER‐positive breast cancer were identified. AI/AN women were found to be less likely to undergo RS testing and, when tested, were more likely to have a high‐risk RS. In the multivariable logistic regression analysis, AI/AN women were found to be significantly more likely to have a high‐risk RS (odds ratio,1.28; 95% confidence interval, 1.01‐1.66). Among untested women, chemotherapy use was higher for AI/AN women; however, the use of chemotherapy was not found to be significantly different between the groups with a high‐risk RS. Using Cox proportional hazards models, AI/AN race was found to be significantly associated with worse overall survival.
Conclusions
AI/AN women were less likely to undergo RS testing compared with NHW women and were more likely to have a high‐risk RS. Reversing the disparity in genomic expression assay testing is critical to ensure guideline‐based breast cancer treatment and improve survival rates for AI/AN women with breast cancer.
Compared with non‐Hispanic White (NHW) women, American Indian and Alaska Native (AI/AN) women with estrogen receptor—positive breast cancer appear to be less likely to undergo genomic expression assay testing. Among tested women, AI/AN patients with breast cancer are more likely to have high‐risk recurrence scores compared with NHW women.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>32926435</pmid><doi>10.1002/cncr.33150</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-0880-2721</orcidid><orcidid>https://orcid.org/0000-0001-6603-2062</orcidid><orcidid>https://orcid.org/0000-0002-2628-0720</orcidid><orcidid>https://orcid.org/0000-0003-4191-0679</orcidid><orcidid>https://orcid.org/0000-0002-5484-5004</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | 21‐gene recurrence score Adult Aged Alaska Native Alaska Natives - genetics American Indian Biomarkers, Tumor - genetics Breast cancer Breast Neoplasms - drug therapy Breast Neoplasms - genetics Chemotherapy Chemotherapy, Adjuvant - methods Confidence intervals Epidemiology Estrogen receptors Estrogens Female Gene expression Gene Expression Profiling - methods Gene Expression Regulation, Neoplastic - drug effects genomic expression assays Humans Indians, North American - genetics Logistic Models Mastectomy Middle Aged Oncology Practice Guidelines as Topic racial disparities Regression analysis Risk SEER Program Statistical analysis Statistical models Survival Survival Analysis Treatment Outcome Young Adult |
| title | Genomic expression assay testing among American Indian and Alaska Native women with breast cancer |
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