No delays in treatment initiation occur in adolescent and young adult (AYA) women with breast cancer in urban settings, and there does not seem to be any significant differences between African American or other races in terms of treatment initiation.
In a retrospective study of an urban population of AYA women with breast cancer, researchers from Georgetown University analyzed stage at diagnosis, hormone receptor status, prevalence of BRCA1/2 mutations, time from diagnosis to treatment, enrollment in clinical trials, and fertility preservation. They presented their results on Friday, December 9, during the San Antonio Breast Cancer Symposium.
From 2006–2015, 161 AYA patients were evaluated—54 identified as African American and 107 as other races (88 Caucasians, 13 Asian, 6 Hispanics). The two groups were similar in age, with a median age of 32 years in the African American group and 33 years in the other races group. Overall rates of genetic testing were high, but significantly fewer African American AYA women underwent testing compared to women of other races (74% versus 87%, respectively; p = 0.050). Although 10% of African American AYAs and 22% of AYAs of other races were found to have a BRCA1/2 deleterious mutation, these were not statistically significant differences.
More AYAs of other races (76%) compared to African American AYAs (57%) participated in a clinical trial when one had been discussed or offered. Of note, 35% of the other races group pursued fertility preservation, but only 10% of African American women did (p = 0.001), which may be because 61% of African American and 34% of AYAs of other races had children at the time of diagnosis.
No statistical differences were seen in the percentage of women who presented with more advanced stages of cancer between African American AYAs (31%) and those of other races (19%); similar rates of triple negativity occurred in African American (25%) and patients of other races (22%) and median time to treatment (37 days for the African American group versus 36 days for the other races group).
The researchers concluded, “The clinical trial participation of AYAs who had previously discussed clinical trials with their physician was very high.”