Discussion
obesity, Obesity, Breast Cancer, tumor, HR+ BC, overweight, Cancer
OBESITY, OBESITY, TUMOR, BREAST CANCER, DISEASE, CANCER
We identified disease and patient subgroups with similarities and differences in survival among racial and ethnic groups for participants enrolled in 4 Alliance adjuvant chemotherapy clinical trials for eBC. While race and ethnicity, in general, were not associated with survival when stratified by subtype, non-Hispanic Black patients with HR+/Prior work within the National Comprehensive Cancer Network Breast Cancer Outcomes Database and in the Carolina Breast Cancer Study demonstrated that racial disparities vary by tumor subtype, with differences in survival between non-Hispanic Black and non-Hispanic White patients with HR+ BC and no differences for patients with triple negative or There are multiple plausible explanations for the differences observed between non-Hispanic Black and non-Hispanic White participants with HR+/We found that, overall, young non-Hispanic Black and Hispanic patients have worse OS than young non-Hispanic White patients. It is reported that non-Hispanic Black and Hispanic women are more likely to be diagnosed with BC at a young age compared with non-Hispanic White women.It is unclear why Hispanic participants in this study had significantly worse RFS than non-Hispanic White participants if they had overweight, but there was no such association in patients with obesity. Obesity has been associated with increased BC mortality in several studies, although more recent studies suggest that this association holds in White women but not in Black women.The strengths of this pooled analysis of clinical trials, including prospective collection of survival data with long follow-up, are particularly important given the outcomes of RFS and OS. Within each clinical trial, participants received similar initial treatment, and outcomes have been well ascertained. In addition to adjustment for baseline clinicopathologic risk factors, our analysis was adjusted for chemotherapy treatment received, thereby facilitating study of other factors associated with survival. By studying racial and ethnic disparities in survival in the clinical trial setting, which standardized initial care and treatment, our results emphasize that other factors, such as inequities in subsequent treatment, survivorship care, or biological differences, may contribute to these disparities. As such, this study extends the understanding of potential contributors to disparities in BC survival. We hope this will inform ongoing efforts to mitigate disparities in BC survival, such as patient navigation programs and the GETSET study