Borderline Estrogen Receptor-Positive Breast Cancers in Black and White Women.

ABSTRACT: BACKGROUND:Some breast tumors expressing greater than 1% and less than 10% estrogen receptor (ER) positivity (ER-borderline) are clinically aggressive; others exhibit luminal biology. Prior ER-borderline studies included few black participants. METHODS:Using the Carolina Breast Cancer Study (phase I: 1993-1996; 2: 1996-2001; 3: 2008-2013), a population-based study that oversampled black women, we compared ER-borderline (n?=?217) to ER-positive (n?=?1885) and ER-negative (n?=?757) tumors. PAM50 subtype and risk of recurrence score (ROR-PT, incorporates subtype, proliferation, tumor size) were measured. Relative frequency differences (RFD) were estimated using multivariable linear regression. Disease-free interval (DFI) was evaluated by ER category and endocrine therapy receipt, overall and by race, using Kaplan Meier and Cox models. Statistical tests were two-sided. RESULTS:ER-borderlines were more frequently basal-like (RFD = +37.7%, 95% confidence interval [CI]?=?27.1% to 48.4%) and high ROR-PT (RFD = +52.4%, 95% CI?=?36.8% to 68.0%) relative to ER-positives. Having a high ROR-PT ER-borderline tumor was statistically significantly associated with black race (RFD = +26.2%, 95% CI?=?9.0% to 43.3%). Compared to ER-positives, DFI of ER-borderlines treated with endocrine therapy was poorer but not statistically significantly different (hazard ratio [HR] = 2.03, 95% CI?=?0.89% to 4.65%), whereas DFI was statistically significantly worse for ER-borderlines without endocrine therapy (HR?=?3.33, 95% CI?=?1.84% to 6.02%). However, black women with ER-borderline had worse DFI compared to ER-positives, even when treated with endocrine therapy (HR?=?2.77, 95% CI?=?1.09% to 7.04%). CONCLUSIONS:ER-borderline tumors were genomically heterogeneous, with survival outcomes that differed by endocrine therapy receipt and race. Black race predicted high-risk ER-borderlines and may be associated with poorer endocrine therapy response.

SUBMITTER: Benefield HC 

PROVIDER: S-EPMC7357313 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature