A common breast cancer test may be leading to inappropriate treatment recommendations for some Black women, potentially causing them to forgo beneficial chemotherapy, according to new research from the University of Illinois Chicago.
The 21-gene breast recurrence score test, widely used to guide chemotherapy decisions for patients with estrogen receptor-positive breast cancer, may underestimate the benefits of chemotherapy for Black women, especially younger patients. The study, published in the Journal of the National Comprehensive Cancer Network, analyzed data from over 70,000 women with early-stage, estrogen receptor-positive breast cancer.
Dr. Kent Hoskins (above), senior author and professor of oncology at UIC, stated, “The test could be misguiding treatment.” The researchers found that the test’s cutoff point for recommending chemotherapy may need to be lowered for Black women, though further study is required before making this recommendation.
The disparity is believed to stem from Black women’s tumors being less responsive to estrogen-blocking medications, making chemotherapy more beneficial for them compared to other women. This finding is part of ongoing research at UIC examining outcomes for Black women with estrogen receptor-positive tumors.
Hoskins emphasized that while biological differences in tumors between Black and white women exist, social factors caused by structural racism also play a role. The researchers suggest that the same social determinants of health leading to worse outcomes for Black women in healthcare may also be driving the more aggressive tumor biology.
The study highlights the need for more personalized approaches to cancer treatment that consider racial and ethnic differences in tumor biology and treatment responses.
See “Breast cancer test may make bad chemotherapy recommendations for Black patients “ (January 29, 2024)
