Neoadjuvant Chemotherapy Improves Breast Cancer Recurrence Rates in African Americans

There is a significant disparity in breast cancer mortality between African American and European-American breast cancer patients. A study published in PLOS ONE suggests that neoadjuvant chemotherapy may improve recurrence rates in African Americans, however.

Among premenopausal and menopausal breast cancer patients, African Americans undergo more aggressive treatment and have a 40% higher death rate compared with European-Americans.

Breast cancer recurrence is one of the primary factors for the racial disparity in prognosis and outcomes, and differences in these rates and patterns has not been thoroughly investigated.

For the study, investigators analyzed clinical data from a large cohort of breast cancer patients who were treated at Northside Hospital in Atlanta, GA, from 2005 to 2015. The self-reported races were primarily African American and European-American.

The investigators examined tumor recurrence rates and patterns after hormone, radiation, and chemotherapy, among African American and European-American patients with breast cancer.

“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 compared to European-American breast cancer patients,” said first author Nikita Wright. “The higher incidence of tumor recurrence can contribute to poor prognosis.”

Breast cancer recurrence poses a challenge for oncologists, because regional and distant tumors are more difficult to treat than local tumors, according to the authors.

“Interestingly, we found that neoadjuvant chemotherapy actually reverse 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.”

Additionally, the investigators found that among early-stage breast cancer patients, African Americans showed higher tumor recurrence compared with European-American patients.