Neoadjuvant Chemotherapy Improved Breast Cancer Outcomes Among African Americans

Neoadjuvant chemotherapy decreased recurrence and increased survival in African American patients.

New findings suggest that African American patients with breast cancer may experience better outcomes if they undergo neoadjuvant chemotherapy.

African American patients administered chemotherapy before surgery were less likely to experience recurrence and had higher survival rates, compared with those who had the opposite treatment approach, according to a study published by PLOS One.

The researchers found that African Americans have higher breast cancer recurrence rates compared with European Americans. They also discovered that patients undergoing neoadjuvant chemotherapy had a lower risk of breast cancer recurring in lymph nodes or other organs.

However, African American patients experienced high rates of local recurrence in the breasts compared with European Americans, but this local recurrence may be easier to manage, and is linked to better prognosis, according to the study.

While the rate of breast cancer is similar between both patient groups, African Americans are more likely to be diagnosed with aggressive disease and have a 40% higher death rate, which highlights the need for new treatment strategies for these patients.

Other studies have suggested that the high risk of breast cancer recurrence may be linked to variations in the groups’ respective disease outcomes, but recurrence rate or treatment patterns have not been previously studied.

Included in the study were 10,504 patients with breast cancer treated between 2005 and 2015, and primarily self-reported as African American and European Americans. The investigators examined rates of recurrence after hormone, radiation, and chemotherapy among these patients, according to the study.

Of the included patients, 49 African Americans and 166 European Americans experienced recurrence during the study period.

“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 (treatment following surgery) compared to European-American breast cancer patients,” said first study Nikita Wright, PhD student. “This higher incidence of tumor recurrence can contribute to a poorer prognosis.”

When breast cancer recurs, regional and distant tumors present a significant treatment challenge, compared with local tumors recurring in the breast.

The investigators also discovered that African American patients with minimally invasive breast cancer had higher tumor recurrence compared with European American patients, according to the study.

Perhaps most notably, neoadjuvant chemotherapy was found to drastically decrease recurrence among African American patients. These findings are significant because it may represent a new standard treatment option for these patients that will prevent recurrence and increase survival.

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