Disparities in Metabolic Conditions and Cancer Characteristics among Hispanic Women with Breast Cancer: A Multi-Institutional Study
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Patient Characteristics
2.3. Outcomes and Comparative Group
2.4. Statistical Considerations
3. Results
3.1. Overall Sample Characteristics
3.2. Differences in Patient Characteristics by Hispanic Ethnicities
3.3. Adjusted Association of Mexican Hispanics Ethnicity with Tumor Subtypes Compared to Non-Mexcian Hispanics
3.4. Adjusted Association of Comorbidities with Tumor Subtypes
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Overall Sample | Mexican Hispanics | Non-Mexican Hispanics | p-Value | |
---|---|---|---|---|
N | 1020 | 851 (83.43%) | 169 (16.56%) | |
Age (mean (SD)) | 56.0 (11.9) | 56.1 (11.9) | 55.7 (11.7) | 0.67 |
BMI (mean (SD)) | 30.4 (6.2) | 30.9 (6.2) | 28.0 (5.8) | <0.001 |
Premenopausal women | 345 (33.8%) | 280 (32.9%) | 65 (38.5%) | 0.16 |
Diagnoses | <0.001 | |||
Ductal | 858 (84.4%) | 734 (86.6%) | 124 (73.4%) | |
Lobular | 76 (7.5%) | 53 (6.3%) | 23 (13.6%) | |
Ductal and lobular (mixed) | 20 (2.0%) | 9 (1.1%) | 11 (6.5%) | |
Other | 63 (6.2%) | 52 (6.1%) | 11 (6.5%) | |
Stage of tumor | 0.18 | |||
Stage I/II (early) | 497 (48.7%) | 420 (49.4%) | 77 (45.6%) | |
Stage III/IV (advanced) | 278 (27.3%) | 236 (27.7%) | 42 (24.9%) | |
Unknown | 245 (24.0%) | 195 (22.9%) | 50 (29.6%) | |
Type of surgery | <0.001 | |||
None | 92 (9.1%) | 62 (7.4%) | 30 (17.8%) | |
Lumpectomy | 509 (50.3%) | 455 (54.0%) | 54 (32.0%) | |
Mastectomy | 400 (39.6%) | 321 (38.1%) | 79 (46.7%) | |
Unknown | 10 (1.0%) | 4 (0.5%) | 6 (3.6%) | |
Receptor subtype | ||||
ER+ | 696 (69.9%) | 567 (68.6%) | 129 (76.3%) | 0.045 |
PR+ | 589 (59.2%) | 482 (58.4%) | 107 (63.3%) | 0.23 |
HER2+ | 160 (18.2%) | 129 (18.1%) | 31 (18.3%) | 0.95 |
HR+ | 707 (69.3%) | 578 (67.9%) | 129 (76.3%) | 0.030 |
TNBC | 192 (21.8%) | 158 (22.2%) | 34 (20.1%) | 0.55 |
Comorbidities | ||||
Diabetes mellitus | 261 (25.6%) | 237 (27.8%) | 24 (14.2%) | <0.001 |
Hypertension | 398 (39.0%) | 322 (37.8%) | 76 (45.0%) | 0.083 |
Hyperlipidemia | 298 (29.2%) | 212 (24.9%) | 86 (50.9%) | <0.001 |
Obesity | 489 (47.9%) | 434 (51.0%) | 55 (32.5%) | <0.001 |
Coronary artery disease | 43 (4.2%) | 36 (4.2%) | 7 (4.1%) | 0.96 |
Metabolic abnormalities | 212 (20.8%) | 184 (21.6%) | 28 (16.6%) | 0.14 |
Any comorbidities | 742 (72.7%) | 614 (72.2%) | 128 (75.7%) | 0.34 |
Number of comorbidities | 0.083 | |||
0 | 278 (27.3%) | 237 (27.8%) | 41 (24.3%) | |
1 | 324 (31.8%) | 271 (31.8%) | 53 (31.4%) | |
2 | 206 (20.2%) | 159 (18.7%) | 47 (27.8%) | |
3 | 138 (13.5%) | 120 (14.1%) | 18 (10.7%) | |
4 | 74 (7.3%) | 64 (7.5%) | 10 (5.9%) | |
Hispanic ethnicities/races | NA | |||
Mexican | 851 (83.4%) | 851 (100.0%) | 0 (0.0%) | |
Puerto Rican | 5 (0.5%) | 0 (0.0%) | 5 (3.0%) | |
Cuban | 11 (1.1%) | 0 (0.0%) | 11 (6.5%) | |
South/Central American | 21 (2.1%) | 0 (0.0%) | 21 (12.4%) | |
Spanish NOS/Hispanic NOS | 129 (12.6%) | 0 (0.0%) | 129 (76.3%) | |
Dominican Republic | 3 (0.3%) | 0 (0.0%) | 3 (1.8%) |
ER+ * | PR+ * | |||||||
---|---|---|---|---|---|---|---|---|
PR ** | 95% CI | p-Value | PR ** | 95% CI | p-Value | |||
Non-Mexicans | 1.12 | 1.01 | 1.25 | 0.036 | 1.05 | 0.91 | 1.21 | 0.482 |
Diabetes mellitus | 1.04 | 0.94 | 1.15 | 0.418 | 1.02 | 0.89 | 1.16 | 0.804 |
Hypertension | 1.09 | 1.00 | 1.20 | 0.06 | 1.13 | 1.01 | 1.27 | 0.036 |
Obesity | 1.06 | 0.97 | 1.15 | 0.201 | 1.06 | 0.96 | 1.18 | 0.263 |
Dyslipidemia | 0.97 | 0.88 | 1.07 | 0.515 | 1.01 | 0.89 | 1.14 | 0.884 |
Postmenopausal | 0.99 | 0.9 | 1.08 | 0.796 | 0.9 | 0.8 | 1 | 0.056 |
Diagnosis-IDC (reference) | ||||||||
Lobular | 1.33 | 1.22 | 1.46 | <0.001 | 1.35 | 1.17 | 1.55 | <0.001 |
Lobular and ductal | 1.15 | 0.91 | 1.44 | 0.235 | 1.19 | 0.88 | 1.62 | 0.268 |
Other | 1.10 | 0.94 | 1.30 | 0.236 | 1.08 | 0.86 | 1.35 | 0.499 |
Stage—Early stage (reference) | ||||||||
Advanced stage | 0.86 | 0.77 | 0.97 | 0.01 | 0.87 | 0.76 | 1.00 | 0.053 |
Stage unknown | 1.02 | 0.93 | 1.12 | 0.705 | 1.00 | 0.89 | 1.13 | 0.966 |
Surgery—None (reference) | ||||||||
Lumpectomy | 1.16 | 0.97 | 1.38 | 0.102 | 1.15 | 0.92 | 1.44 | 0.217 |
Mastectomy | 1.07 | 0.9 | 1.28 | 0.436 | 1.09 | 0.87 | 1.36 | 0.439 |
Unknown | 1.01 | 0.6 | 1.71 | 0.972 | 1.25 | 0.73 | 2.13 | 0.413 |
HR+ * | TN * | |||||||
Non-Mexicans | 1.13 | 1.01 | 1.25 | 0.028 | 0.82 | 0.57 | 1.19 | 0.298 |
Diabetes mellitus | 1.01 | 0.92 | 1.12 | 0.788 | 0.82 | 0.57 | 1.17 | 0.268 |
Hypertension | 1.13 | 1.03 | 1.24 | 0.008 | 0.90 | 0.67 | 1.21 | 0.5 |
Obesity | 1.05 | 0.97 | 1.14 | 0.226 | 1.01 | 0.78 | 1.31 | 0.939 |
Dyslipidemia | 0.98 | 0.89 | 1.08 | 0.703 | 1.24 | 0.9 | 1.7 | 0.185 |
Postmenopausal | 0.97 | 0.88 | 1.06 | 0.488 | 0.89 | 0.68 | 1.16 | 0.377 |
Diagnosis-IDC (reference) | ||||||||
Lobular | 1.28 | 1.16 | 1.41 | <0.001 | 0.30 | 0.13 | 0.70 | 0.005 |
Lobular and ductal | 1.08 | 0.85 | 1.38 | 0.533 | 0.79 | 0.27 | 2.33 | 0.67 |
Other | 1.00 | 0.84 | 1.2 | 0.982 | 0.78 | 0.44 | 1.37 | 0.381 |
Stage—Early stage (reference) | ||||||||
Advanced stage | 0.87 | 0.78 | 0.98 | 0.019 | 1.08 | 0.8 | 1.46 | 0.619 |
Unknown | 0.99 | 0.90 | 1.09 | 0.768 | 1.1 | 0.8 | 1.52 | 0.549 |
Surgery—None (reference) | ||||||||
Lumpectomy | 1.11 | 0.94 | 1.32 | 0.221 | 0.57 | 0.38 | 0.85 | 0.006 |
Mastectomy | 1.03 | 0.87 | 1.22 | 0.72 | 0.61 | 0.42 | 0.89 | 0.011 |
Unknown | 0.89 | 0.52 | 1.54 | 0.68 | 0.78 | 0.22 | 2.76 | 0.702 |
ER+ * | PR+ * | ||||||||
---|---|---|---|---|---|---|---|---|---|
PR ** | 95% CI | p-Value | PR ** | 95% CI | p-Value | ||||
Model 1 | Any comorbidities | 1.03 | 0.94 | 1.14 | 0.498 | 1.03 | 0.91 | 1.16 | 0.669 |
Model 2 | Metabolic syndrome | 1.14 | 1.04 | 1.25 | 0.003 | 1.23 | 1.10 | 1.39 | <0.001 |
Model 3 | One comorbidity | 1.00 | 0.9 | 1.13 | 0.934 | 0.98 | 0.85 | 1.12 | 0.745 |
Two | 0.99 | 0.87 | 1.12 | 0.857 | 0.95 | 0.81 | 1.12 | 0.571 | |
Three | 1.09 | 0.96 | 1.25 | 0.188 | 1.17 | 0.99 | 1.38 | 0.066 | |
Four | 1.23 | 1.08 | 1.4 | 0.002 | 1.27 | 1.06 | 1.52 | 0.008 | |
HR+ * | TNBC * | ||||||||
Model 1 | Any comorbidities | 1.06 | 0.96 | 1.17 | 0.275 | 1.08 | 0.8 | 1.44 | 0.625 |
Model 2 | Metabolic syndrome | 1.15 | 1.05 | 1.26 | 0.003 | 0.86 | 0.62 | 1.21 | 0.402 |
Model 3 | One comorbidity | 1.02 | 0.91 | 1.14 | 0.736 | 1.08 | 0.78 | 1.51 | 0.64 |
Two | 1.02 | 0.90 | 1.16 | 0.72 | 1.19 | 0.83 | 1.71 | 0.352 | |
Three | 1.12 | 0.98 | 1.29 | 0.086 | 1.10 | 0.71 | 1.70 | 0.678 | |
Four | 1.24 | 1.08 | 1.42 | 0.003 | 0.68 | 0.35 | 1.31 | 0.248 |
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Jabbal, I.S.; Dwivedi, A.; Bilani, N.; Dominguez, B.; Botrus, G.; Nahleh, Z. Disparities in Metabolic Conditions and Cancer Characteristics among Hispanic Women with Breast Cancer: A Multi-Institutional Study. Cancers 2022, 14, 3411. https://doi.org/10.3390/cancers14143411
Jabbal IS, Dwivedi A, Bilani N, Dominguez B, Botrus G, Nahleh Z. Disparities in Metabolic Conditions and Cancer Characteristics among Hispanic Women with Breast Cancer: A Multi-Institutional Study. Cancers. 2022; 14(14):3411. https://doi.org/10.3390/cancers14143411
Chicago/Turabian StyleJabbal, Iktej S., Alok Dwivedi, Nadeem Bilani, Barbara Dominguez, Gehan Botrus, and Zeina Nahleh. 2022. "Disparities in Metabolic Conditions and Cancer Characteristics among Hispanic Women with Breast Cancer: A Multi-Institutional Study" Cancers 14, no. 14: 3411. https://doi.org/10.3390/cancers14143411