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Asad S , Barcenas CH , Bleicher RJ , Cohen AL , Javid SH , Levine EG , Lin NU , Moy B , Niland J , Wolff AC , Hassett MJ , Stover DG
Sociodemographic Factors Associated With Rapid Relapse in Triple-Negative Breast Cancer: A Multi-Institution Study
J Natl Compr Canc Netw. 2021 Mar 10;19(7) :797-804
PMID: 33691275 URL: https://www.ncbi.nlm.nih.gov/pubmed/33691275
AbstractBACKGROUND: Triple-negative breast cancer (TNBC) accounts for disproportionately poor outcomes in breast cancer, driven by a subset of rapid-relapse TNBC (rrTNBC) with marked chemoresistance, rapid metastatic spread, and poor survival. Our objective was to evaluate clinicopathologic and sociodemographic features associated with rrTNBC. METHODS: We included patients diagnosed with stage I-III TNBC in 1996 through 2012 who received chemotherapy at 1 of 10 academic cancer centers. rrTNBC was defined as a distant metastatic recurrence event or death ≤24 months after diagnosis. Features associated with rrTNBC were included in a multivariable logistic model upon which backward elimination was performed with a P<.10 criterion, with a final multivariable model applied to training (70%) and independent validation (30%) cohorts. RESULTS: Among all patients with breast cancer treated at these centers, 3,016 fit the inclusion criteria. Training cohort (n=2,112) bivariable analyses identified disease stage, insurance type, age, body mass index, race, and income as being associated with rrTNBC (P<.10). In the final multivariable model, rrTNBC was significantly associated with higher disease stage (adjusted odds ratio for stage III vs I, 16.0; 95% CI, 9.8-26.2; P<.0001), Medicaid/indigent insurance, lower income (by 2000 US Census tract), and younger age at diagnosis. Model performance was consistent between the training and validation cohorts. In sensitivity analyses, insurance type, low income, and young age were associated with rrTNBC among patients with stage I/II but not stage III disease. When comparing rrTNBC versus late relapse (>24 months), we found that insurance type and young age remained significant. CONCLUSIONS: Timing of relapse in TNBC is associated with stage of disease and distinct sociodemographic features, including insurance type, income, and age at diagnosis.
Notes1540-1413 Asad, Sarah Barcenas, Carlos H Bleicher, Richard J Cohen, Adam L Javid, Sara H Levine, Ellis G Lin, Nancy U Moy, Beverly Niland, Joyce Wolff, Antonio C Hassett, Michael J Stover, Daniel G Journal Article United States J Natl Compr Canc Netw. 2021 Mar 10:1-8. doi: 10.6004/jnccn.2020.7659.