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Aboriginal and Torres Strait Islander Females and Survival from Breast Cancer
Alice R T Bergin1,2, Luc Te Marvelde3, Roger L Milne4,5,6
1Peter MacCallum Cancer Centre, Melbourne, Australia.
Summary
Aboriginal females in Australia face higher breast cancer mortality due to socioeconomic and clinical factors. Reduced tumor-infiltrating lymphocytes may also contribute to poorer outcomes, highlighting the need for equitable care.
Area of Science:
- Oncology
- Epidemiology
- Immunology
Background:
- Aboriginal and Torres Strait Islander females in Australia experience disproportionately higher breast cancer incidence and mortality rates despite universal healthcare access.
- Existing research indicates survival disparities, necessitating an investigation into contributing factors.
Purpose of the Study:
- To investigate the clinical, pathological, demographic, and socioeconomic factors associated with breast cancer survival disparities in Aboriginal females compared to non-Aboriginal females in Australia.
- To explore the role of tumor-infiltrating lymphocytes (sTILs) in breast cancer outcomes for Aboriginal females.
Main Methods:
- A retrospective analysis of breast cancer cases in Victoria, Australia, comparing Aboriginal (n=395) and non-Aboriginal (n=57,618) females.
- Cox regression was used to estimate hazard ratios for all-cause and breast cancer-specific mortality.
- Tumor-infiltrating lymphocytes (sTILs) were evaluated in a subset of Aboriginal females and compared to The Cancer Genome Atlas (TCGA) data.
Main Results:
- Aboriginal females were diagnosed at younger ages, with more advanced disease, and from more disadvantaged, non-metropolitan areas.
- Age-adjusted analysis showed higher all-cause mortality risk for Aboriginal females, which diminished after adjusting for stage and grade for breast cancer-specific mortality.
- Breast cancers in Aboriginal females exhibited significantly reduced sTILs in luminal and triple-negative subtypes compared to TCGA data.
Conclusions:
- Breast cancer mortality in Aboriginal females is influenced by socioeconomic, geographic, and clinical factors.
- Poorer outcomes were observed in Aboriginal females even with tumor features typically associated with favorable prognosis.
- Reduced immune infiltrate (sTILs) in tumors warrants further investigation into biological and environmental factors impacting outcomes.
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