Synchronous Breast Cancers: Comparison of Racial Distribution in Pathologic Parameters of Aggressive Behavior
Christina Duckworth, Lucy Xu, George Birdsong, Iva Trgovcic, Marina Mosunjac. Emory University, Atlanta, GA
Background: Synchronous breast cancers (SBC) are defined as a second tumor diagnosed within three months from the diagnosis of a first tumor. While a variety of risk factors and prognostic parameters have been associated with the overall incidence of breast cancer, little is known about cancers that are synchronous. We describe a relatively large retrospective clinicopathologic study investigating the racial distribution of SBC in patients from a tertiary care and an inner city hospital.
Design: A retrospective search of all bilateral breast biopsies performed at our tertiary care and inner city hospitals between the years 2005 and 2010 was performedAmong these, 50 cases were identified as being temporally synchronous. Electronic medical records were used for the extraction of demographic data, clinical notes, imaging studies and pathology reports.
Results: 30 patients were African American (AA), 17 were Caucasian (CAU); and 3 were Hispanic (H); all were female. The age range was 33-80 years, with median age of 55 years for H, 58 years for AA, and 62 years for CAU women, respectively. The most common histologic type of tumor was infiltrating ductal carcinoma, followed by ductal carcinoma in situ, infiltrating lobular carcinoma, and lobular carcinoma in situ. AA patients comprised (3/4) 75% of those with T4 and (5/6) 83% of T3 pathologic stage, as well as (18/28) 64% of carcinomas with positive lymph node status. Among cancers with high grade histology, (22/26) 85% were seen in AA women. CAU women comprised the remainder of patients with high stage cancers, (9/18) 32% of the carcinomas with positive lymph node status, and 7.6% those with high grade histology. The cancers in H women were (1/28) 3.6% of carcinomas with positive lymph node status and (2/26) 7.7% of those with high grade histology. Assessment of hormones receptor status revealed that 8 (7.8%) cases were found to be triple negative for ER, PR, and HER2-neu, all of which were in AA patients.
Conclusions: Our study investigates the difference in racial distributions of SBC over a 5 year time period. Overall, AA patients presented at a younger age, with worse histology, and with a higher pathologic stage. Additionally, all reported triple negative carcinomas were found exclusively in AA women. While it is known that AA women have an overall higher mortality rate from breast cancer, our study suggests that this may be due in part to more aggressive tumor biology. Synchronous cancers, like solitary cancers, also appear to present at a younger age in AA women when compared to Caucasians.
Wednesday, March 6, 2013 1:00 PM
Poster Session VI # 25, Wednesday Afternoon