The following article features coverage from the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting. Click here to read more of Cancer Therapy Advisor‘s conference coverage.

Racial disparities in distant metastases among patients with breast cancer exist independent of patients’ age and stage at diagnosis, according to an analysis presented at the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting.

“Black women diagnosed with breast cancer are more likely to have a poor prognosis, regardless of breast cancer subtype,” Julia Blanter, MD, of Icahn School of Medicine at Mount Sinai in New York, New York, said when presenting this research at ASCO 2021.

Dr Blanter noted that Black women have a lower incidence of breast cancer compared with White women, but Black women have the highest breast cancer death rate of all racial and ethnic groups. This higher death rate is often attributed to late stage at diagnosis, Dr Blanter said, adding that the leading cause of death from breast cancer is distant metastases.

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With this in mind, Dr Blanter and colleagues conducted a study to determine differences in distant metastases rates among Black and White breast cancer patients.

The researchers analyzed medical records from patients in the Mount Sinai Health System who had participated in a study on insulin resistance, race, and breast cancer prognosis. The analysis included 441 patients, 340 of whom were White and 101 of whom were Black.

The median follow-up time was significantly longer for White patients than for Black patients — 3.12 years and 2.51 years, respectively (P =.017).

Black patients were significantly (P <.0001) more likely have a higher disease stage at diagnosis. Specifically, 58.4% of Black patients had stage I disease at diagnosis, compared with 83.5% of White patients.

The rate of distant metastases after diagnosis was significantly higher in Black patients than in White patients — 6.9% and 1.2%, respectively (P =.004).

A multivariate analysis adjusting for age, race, and stage at diagnosis revealed a higher likelihood of distant metastases among Black patients (odds ratio [OR] 5.8; 95% CI, 1.3-25.2), younger patients (OR for age [years], 0.9; 95% CI, 0.9-1.0), and those with a more advanced stage at diagnosis (OR not provided).

“[B]lack women demonstrated a far higher percentage of distant metastases after diagnosis, even after accounting for age and stage at diagnosis, further suggesting that racial disparities still exist in the development of distant metastases, independent from a late-stage diagnosis,” Dr Blanter concluded.

She added that future studies in which researchers assess surveillance and treatment differences might reveal more sources of existing disparities.

Disclosures: This research was supported by the National Institutes of Health. Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Read more of Cancer Therapy Advisor’s coverage of the 2021 ASCO Annual Meeting by visiting the conference page.


Blanter J, Ramer I, Ray J, et al. Distant metastases after diagnosis: racial disparities in breast cancer outcomes. J Clin Oncol. 2021;39:(suppl 15; abstr 107). doi:10.1200/JCO.2021.39.15_suppl.1084