Racial Differences in PAM50 Subtypes in the Carolina Breast Cancer Study

Melissa A Troester; Xuezheng Sun; Emma H Allott; Joseph Geradts; Stephanie M Cohen; Chiu-Kit Tse; Erin L Kirk; Leigh B Thorne; Michelle Mathews; Yan Li; Zhiyuan Hu; Whitney R Robinson; Katherine A Hoadley; Olufunmilayo I Olopade; Katherine E Reeder-Hayes; H Shelton Earp; Andrew F Olshan; Lisa A Carey; Charles M Perou

doi:10.1093/jnci/djx135

Racial Differences in PAM50 Subtypes in the Carolina Breast Cancer Study

Melissa A Troester, Xuezheng Sun, Emma H Allott, Joseph Geradts, Stephanie M Cohen, Chiu-Kit Tse, Erin L Kirk, Leigh B Thorne, Michelle Mathews, Yan Li, Zhiyuan Hu, Whitney R Robinson, Katherine A Hoadley, Olufunmilayo I Olopade, Katherine E Reeder-Hayes, H Shelton Earp, Andrew F Olshan, Lisa A Carey, Charles M Perou

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Abstract

Background: African American breast cancer patients have lower frequency of hormone receptor-positive (HR+)/human epidermal growth factor receptor 2 (HER2)-negative disease and higher subtype-specific mortality. Racial differences in molecular subtype within clinically defined subgroups are not well understood.

Methods: Using data and biospecimens from the population-based Carolina Breast Cancer Study (CBCS) Phase 3 (2008-2013), we classified 980 invasive breast cancers using RNA expression-based PAM50 subtype and recurrence (ROR) score that reflects proliferation and tumor size. Molecular subtypes (Luminal A, Luminal B, HER2-enriched, and Basal-like) and ROR scores (high vs low/medium) were compared by race (blacks vs whites) and age (≤50 years vs > 50 years) using chi-square tests and analysis of variance tests.

Results: Black women of all ages had a statistically significantly lower frequency of Luminal A breast cancer (25.4% and 33.6% in blacks vs 42.8% and 52.1% in whites; younger and older, respectively). All other subtype frequencies were higher in black women (case-only odds ratio [OR] = 3.11, 95% confidence interval [CI] = 2.22 to 4.37, for Basal-like; OR = 1.45, 95% CI = 1.02 to 2.06, for Luminal B; OR = 2.04, 95% CI = 1.33 to 3.13, for HER2-enriched). Among clinically HR+/HER2- cases, Luminal A subtype was less common and ROR scores were statistically significantly higher among black women.

Conclusions: Multigene assays highlight racial disparities in tumor subtype distribution that persist even in clinically defined subgroups. Differences in tumor biology (eg, HER2-enriched status) may be targetable to reduce disparities among clinically ER+/HER2- cases.

Original language	English
Pages (from-to)	176-182
Number of pages	7
Journal	Journal of the National Cancer Institute
Volume	110
Issue number	2
Early online date	01 Aug 2017
DOIs	https://doi.org/10.1093/jnci/djx135
Publication status	Published - 01 Feb 2018

Keywords

Adult
African Americans
Aged
Breast Neoplasms/chemistry
Cell Proliferation
European Continental Ancestry Group
Female
Humans
Middle Aged
RNA, Neoplasm/analysis
Receptor, ErbB-2/analysis
Receptors, Estrogen/analysis
Receptors, Progesterone/analysis
Recurrence
Tumor Burden
Young Adult

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1093/jnci/djx135Licence: Unspecified

Racial Differences in Subtype and PAM50 Biomarker Status in the Carolina Breast Cancer Study
© The Author 2017. Published by Oxford University Press. All rights reserved. This work is made available online in accordance with the publisher’s policies. Please refer to any applicable terms of use of the publisher.
Accepted author manuscript, 238 KBLicence: Unspecified

Emma Allott
- E.Allottqub.acuk
Person: Academic

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Troester, M. A., Sun, X., Allott, E. H., Geradts, J., Cohen, S. M., Tse, C.-K., Kirk, E. L., Thorne, L. B., Mathews, M., Li, Y., Hu, Z., Robinson, W. R., Hoadley, K. A., Olopade, O. I., Reeder-Hayes, K. E., Earp, H. S., Olshan, A. F., Carey, L. A., & Perou, C. M. (2018). Racial Differences in PAM50 Subtypes in the Carolina Breast Cancer Study. Journal of the National Cancer Institute, 110(2), 176-182. https://doi.org/10.1093/jnci/djx135

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title = "Racial Differences in PAM50 Subtypes in the Carolina Breast Cancer Study",

abstract = "Background: African American breast cancer patients have lower frequency of hormone receptor-positive (HR+)/human epidermal growth factor receptor 2 (HER2)-negative disease and higher subtype-specific mortality. Racial differences in molecular subtype within clinically defined subgroups are not well understood.Methods: Using data and biospecimens from the population-based Carolina Breast Cancer Study (CBCS) Phase 3 (2008-2013), we classified 980 invasive breast cancers using RNA expression-based PAM50 subtype and recurrence (ROR) score that reflects proliferation and tumor size. Molecular subtypes (Luminal A, Luminal B, HER2-enriched, and Basal-like) and ROR scores (high vs low/medium) were compared by race (blacks vs whites) and age (≤50 years vs > 50 years) using chi-square tests and analysis of variance tests.Results: Black women of all ages had a statistically significantly lower frequency of Luminal A breast cancer (25.4% and 33.6% in blacks vs 42.8% and 52.1% in whites; younger and older, respectively). All other subtype frequencies were higher in black women (case-only odds ratio [OR] = 3.11, 95% confidence interval [CI] = 2.22 to 4.37, for Basal-like; OR = 1.45, 95% CI = 1.02 to 2.06, for Luminal B; OR = 2.04, 95% CI = 1.33 to 3.13, for HER2-enriched). Among clinically HR+/HER2- cases, Luminal A subtype was less common and ROR scores were statistically significantly higher among black women.Conclusions: Multigene assays highlight racial disparities in tumor subtype distribution that persist even in clinically defined subgroups. Differences in tumor biology (eg, HER2-enriched status) may be targetable to reduce disparities among clinically ER+/HER2- cases.",

keywords = "Adult, African Americans, Aged, Breast Neoplasms/chemistry, Cell Proliferation, European Continental Ancestry Group, Female, Humans, Middle Aged, RNA, Neoplasm/analysis, Receptor, ErbB-2/analysis, Receptors, Estrogen/analysis, Receptors, Progesterone/analysis, Recurrence, Tumor Burden, Young Adult",

author = "Troester, {Melissa A} and Xuezheng Sun and Allott, {Emma H} and Joseph Geradts and Cohen, {Stephanie M} and Chiu-Kit Tse and Kirk, {Erin L} and Thorne, {Leigh B} and Michelle Mathews and Yan Li and Zhiyuan Hu and Robinson, {Whitney R} and Hoadley, {Katherine A} and Olopade, {Olufunmilayo I} and Reeder-Hayes, {Katherine E} and Earp, {H Shelton} and Olshan, {Andrew F} and Carey, {Lisa A} and Perou, {Charles M}",

year = "2018",

month = feb,

day = "1",

doi = "10.1093/jnci/djx135",

language = "English",

volume = "110",

pages = "176--182",

journal = "Journal of the National Cancer Institute",

issn = "0027-8874",

publisher = "Oxford University Press",

number = "2",

}

Troester, MA, Sun, X, Allott, EH, Geradts, J, Cohen, SM, Tse, C-K, Kirk, EL, Thorne, LB, Mathews, M, Li, Y, Hu, Z, Robinson, WR, Hoadley, KA, Olopade, OI, Reeder-Hayes, KE, Earp, HS, Olshan, AF, Carey, LA & Perou, CM 2018, 'Racial Differences in PAM50 Subtypes in the Carolina Breast Cancer Study', Journal of the National Cancer Institute, vol. 110, no. 2, pp. 176-182. https://doi.org/10.1093/jnci/djx135

TY - JOUR

T1 - Racial Differences in PAM50 Subtypes in the Carolina Breast Cancer Study

AU - Troester, Melissa A

AU - Sun, Xuezheng

AU - Allott, Emma H

AU - Geradts, Joseph

AU - Cohen, Stephanie M

AU - Tse, Chiu-Kit

AU - Kirk, Erin L

AU - Thorne, Leigh B

AU - Mathews, Michelle

AU - Li, Yan

AU - Hu, Zhiyuan

AU - Robinson, Whitney R

AU - Hoadley, Katherine A

AU - Olopade, Olufunmilayo I

AU - Reeder-Hayes, Katherine E

AU - Earp, H Shelton

AU - Olshan, Andrew F

AU - Carey, Lisa A

AU - Perou, Charles M

PY - 2018/2/1

Y1 - 2018/2/1

N2 - Background: African American breast cancer patients have lower frequency of hormone receptor-positive (HR+)/human epidermal growth factor receptor 2 (HER2)-negative disease and higher subtype-specific mortality. Racial differences in molecular subtype within clinically defined subgroups are not well understood.Methods: Using data and biospecimens from the population-based Carolina Breast Cancer Study (CBCS) Phase 3 (2008-2013), we classified 980 invasive breast cancers using RNA expression-based PAM50 subtype and recurrence (ROR) score that reflects proliferation and tumor size. Molecular subtypes (Luminal A, Luminal B, HER2-enriched, and Basal-like) and ROR scores (high vs low/medium) were compared by race (blacks vs whites) and age (≤50 years vs > 50 years) using chi-square tests and analysis of variance tests.Results: Black women of all ages had a statistically significantly lower frequency of Luminal A breast cancer (25.4% and 33.6% in blacks vs 42.8% and 52.1% in whites; younger and older, respectively). All other subtype frequencies were higher in black women (case-only odds ratio [OR] = 3.11, 95% confidence interval [CI] = 2.22 to 4.37, for Basal-like; OR = 1.45, 95% CI = 1.02 to 2.06, for Luminal B; OR = 2.04, 95% CI = 1.33 to 3.13, for HER2-enriched). Among clinically HR+/HER2- cases, Luminal A subtype was less common and ROR scores were statistically significantly higher among black women.Conclusions: Multigene assays highlight racial disparities in tumor subtype distribution that persist even in clinically defined subgroups. Differences in tumor biology (eg, HER2-enriched status) may be targetable to reduce disparities among clinically ER+/HER2- cases.

AB - Background: African American breast cancer patients have lower frequency of hormone receptor-positive (HR+)/human epidermal growth factor receptor 2 (HER2)-negative disease and higher subtype-specific mortality. Racial differences in molecular subtype within clinically defined subgroups are not well understood.Methods: Using data and biospecimens from the population-based Carolina Breast Cancer Study (CBCS) Phase 3 (2008-2013), we classified 980 invasive breast cancers using RNA expression-based PAM50 subtype and recurrence (ROR) score that reflects proliferation and tumor size. Molecular subtypes (Luminal A, Luminal B, HER2-enriched, and Basal-like) and ROR scores (high vs low/medium) were compared by race (blacks vs whites) and age (≤50 years vs > 50 years) using chi-square tests and analysis of variance tests.Results: Black women of all ages had a statistically significantly lower frequency of Luminal A breast cancer (25.4% and 33.6% in blacks vs 42.8% and 52.1% in whites; younger and older, respectively). All other subtype frequencies were higher in black women (case-only odds ratio [OR] = 3.11, 95% confidence interval [CI] = 2.22 to 4.37, for Basal-like; OR = 1.45, 95% CI = 1.02 to 2.06, for Luminal B; OR = 2.04, 95% CI = 1.33 to 3.13, for HER2-enriched). Among clinically HR+/HER2- cases, Luminal A subtype was less common and ROR scores were statistically significantly higher among black women.Conclusions: Multigene assays highlight racial disparities in tumor subtype distribution that persist even in clinically defined subgroups. Differences in tumor biology (eg, HER2-enriched status) may be targetable to reduce disparities among clinically ER+/HER2- cases.

KW - Adult

KW - African Americans

KW - Aged

KW - Breast Neoplasms/chemistry

KW - Cell Proliferation

KW - European Continental Ancestry Group

KW - Female

KW - Humans

KW - Middle Aged

KW - RNA, Neoplasm/analysis

KW - Receptor, ErbB-2/analysis

KW - Receptors, Estrogen/analysis

KW - Receptors, Progesterone/analysis

KW - Recurrence

KW - Tumor Burden

KW - Young Adult

U2 - 10.1093/jnci/djx135

DO - 10.1093/jnci/djx135

M3 - Article

C2 - 28859290

SN - 0027-8874

VL - 110

SP - 176

EP - 182

JO - Journal of the National Cancer Institute

JF - Journal of the National Cancer Institute

IS - 2

ER -

Racial Differences in PAM50 Subtypes in the Carolina Breast Cancer Study

Abstract

Keywords

UN SDGs

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Emma Allott

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