Racial Disparities in Triple Negative Breast Cancer: A Review of the Role of Biologic and Non-biologic Factors
Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer that lacks expression of the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor (HER2). TNBC constitutes about 15–30 percent of all diagnosed invasive breast cancer cases in the...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-12-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2020.576964/full |
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| author | Om Prakash Fokhrul Hossain Denise Danos Adam Lassak Richard Scribner Lucio Miele |
| author_facet | Om Prakash Fokhrul Hossain Denise Danos Adam Lassak Richard Scribner Lucio Miele |
| author_sort | Om Prakash |
| collection | DOAJ |
| description | Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer that lacks expression of the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor (HER2). TNBC constitutes about 15–30 percent of all diagnosed invasive breast cancer cases in the United States. African-American (AA) women have high prevalence of TNBC with worse clinical outcomes than European-American (EA) women. The contributing factors underlying racial disparities have been divided into two major categories based on whether they are related to lifestyle (non-biologic) or unrelated to lifestyle (biologic). Our objective in the present review article was to understand the potential interactions by which these risk factors intersect to drive the initiation and development of the disparities resulting in the aggressive TNBC subtypes in AA women more likely than in EA women. To reach our goal, we conducted literature searches using MEDLINE/PubMed to identify relevant articles published from 2005 to 2019 addressing breast cancer disparities primarily among AA and EA women in the United States. We found that disparities in TNBC may be attributed to racial differences in biological factors, such as tumor heterogeneity, population genetics, somatic genomic mutations, and increased expression of genes in AA breast tumors which have direct link to breast cancer. In addition, a large number of non-biologic factors, including socioeconomic deprivation adversities associated with poverty, social stress, unsafe neighborhoods, lack of healthcare access and pattern of reproductive factors, can promote comorbid diseases such as obesity and diabetes which may adversely contribute to the aggression of TNBC biology in AA women. Further, the biological risk factors directly linked to TNBC in AA women may potentially interact with non-biologic factors to promote a higher prevalence of TNBC, more aggressive biology, and poor survival. The relative contributions of the biologic and non-biologic factors and their potential interactions is essential to our understanding of disproportionately high burden and poor survival rates of AA women with TNBC. |
| first_indexed | 2024-12-21T14:38:49Z |
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| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-12-21T14:38:49Z |
| publishDate | 2020-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-9eff92f11540443da14e7f5c5fe90e332022-12-21T19:00:16ZengFrontiers Media S.A.Frontiers in Public Health2296-25652020-12-01810.3389/fpubh.2020.576964576964Racial Disparities in Triple Negative Breast Cancer: A Review of the Role of Biologic and Non-biologic FactorsOm Prakash0Fokhrul Hossain1Denise Danos2Adam Lassak3Richard Scribner4Lucio Miele5Louisiana Health Sciences Center, School of Medicine, New Orleans, LA, United StatesLouisiana Health Sciences Center, School of Medicine, New Orleans, LA, United StatesLouisiana Health Sciences Center, School of Medicine, New Orleans, LA, United StatesLouisiana Health Sciences Center, School of Medicine, New Orleans, LA, United StatesDepartment of Public Health and Preventive Medicine, St. George's University, True Blue, GrenadaLouisiana Health Sciences Center, School of Medicine, New Orleans, LA, United StatesTriple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer that lacks expression of the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor (HER2). TNBC constitutes about 15–30 percent of all diagnosed invasive breast cancer cases in the United States. African-American (AA) women have high prevalence of TNBC with worse clinical outcomes than European-American (EA) women. The contributing factors underlying racial disparities have been divided into two major categories based on whether they are related to lifestyle (non-biologic) or unrelated to lifestyle (biologic). Our objective in the present review article was to understand the potential interactions by which these risk factors intersect to drive the initiation and development of the disparities resulting in the aggressive TNBC subtypes in AA women more likely than in EA women. To reach our goal, we conducted literature searches using MEDLINE/PubMed to identify relevant articles published from 2005 to 2019 addressing breast cancer disparities primarily among AA and EA women in the United States. We found that disparities in TNBC may be attributed to racial differences in biological factors, such as tumor heterogeneity, population genetics, somatic genomic mutations, and increased expression of genes in AA breast tumors which have direct link to breast cancer. In addition, a large number of non-biologic factors, including socioeconomic deprivation adversities associated with poverty, social stress, unsafe neighborhoods, lack of healthcare access and pattern of reproductive factors, can promote comorbid diseases such as obesity and diabetes which may adversely contribute to the aggression of TNBC biology in AA women. Further, the biological risk factors directly linked to TNBC in AA women may potentially interact with non-biologic factors to promote a higher prevalence of TNBC, more aggressive biology, and poor survival. The relative contributions of the biologic and non-biologic factors and their potential interactions is essential to our understanding of disproportionately high burden and poor survival rates of AA women with TNBC.https://www.frontiersin.org/articles/10.3389/fpubh.2020.576964/fulltriple negative breast cancerracial disparitiesAfrican-American womennon-hispanic whitessocioeconomic statusobesity |
| spellingShingle | Om Prakash Fokhrul Hossain Denise Danos Adam Lassak Richard Scribner Lucio Miele Racial Disparities in Triple Negative Breast Cancer: A Review of the Role of Biologic and Non-biologic Factors Frontiers in Public Health triple negative breast cancer racial disparities African-American women non-hispanic whites socioeconomic status obesity |
| title | Racial Disparities in Triple Negative Breast Cancer: A Review of the Role of Biologic and Non-biologic Factors |
| title_full | Racial Disparities in Triple Negative Breast Cancer: A Review of the Role of Biologic and Non-biologic Factors |
| title_fullStr | Racial Disparities in Triple Negative Breast Cancer: A Review of the Role of Biologic and Non-biologic Factors |
| title_full_unstemmed | Racial Disparities in Triple Negative Breast Cancer: A Review of the Role of Biologic and Non-biologic Factors |
| title_short | Racial Disparities in Triple Negative Breast Cancer: A Review of the Role of Biologic and Non-biologic Factors |
| title_sort | racial disparities in triple negative breast cancer a review of the role of biologic and non biologic factors |
| topic | triple negative breast cancer racial disparities African-American women non-hispanic whites socioeconomic status obesity |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2020.576964/full |
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