Highlights
- •Screen detected cancer in AA women was less likely to manifest as AD and more likely to present with calcifications (MG).
- •Even accounting for tumor histology, AA women were more likely to have screen detected oval/round malignant masses.
- •Controlled for histology, AA women were more likely to have masses with non-spiculated (MG) and circumscribed margins (US).
- •AA women were also more likely to present clinically with high density masses demonstrating posterior enhancement.
- •AA women were more likely to have non-dense breast composition and more likely to have TNBC subtype than NLW women.
- •AD= Architectural distortion, MG= Mammogram, US= Ultrasound, TNBC= Triple negative breast cancer.
Abstract
Purpose
To assess differences in the mammographic and sonographic appearance of breast cancer
in African American (AA) and Non-Latina White (NLW) women.
Methods
We identified AA and NLW women with biopsy proven ductal carcinoma in situ or invasive
breast cancer between June 1, 2015 and May 31, 2018. Racial differences in Breast
Imaging and Reporting Data System (BI-RADS) imaging features were analyzed by imaging
cohorts, i.e. screen detected vs. clinical presentation, using logistic regression
adjusted for histology and molecular subtypes.
Results
We analyzed 270 AA women with 278 cancers (166 screen detected, 112 clinical) and
586 NLW women with 599 cancers (397 screen detected, 202 clinical). Compared with
NLW women, AA women had higher rates of non-dense breast composition (almost entirely
fatty 12.0% vs. 4.6%, scattered fibroglandular 50.9% vs. 45.2%; overall P < 0001)
in both cohorts and were less likely to have screen detected architectural distortion,
(odds ratio (OR) = 0.38, 95% CI 0.18–0.80). AA women were less likely than NLW women
to have screen detected irregular than oval/round masses (mammography: OR = 0.36,
95% CI 0.19–0.68; sonography: OR = 0.48, 95% CI 0.24–0.94), and more likely to present
clinically with high density masses (OR = 3.03, 95% CI 1.12–8.20) demonstrating posterior
enhancement (OR = 3.02, 95% CI 1.11–8.27).
Conclusion
There are racial differences in the mammographic and sonographic appearance of breast
cancer even after accounting for higher rates of triple negative breast cancer in
AA women. Understanding these differences may provide breast imagers with a framework
to approach breast cancer diagnosis in the AA population in clinical practice.
Keywords
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Article Info
Publication History
Published online: November 16, 2022
Accepted:
November 8,
2022
Received in revised form:
October 17,
2022
Received:
July 19,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
