The Patients Missing From Breast Cancer Data

A single label can hide a lot. In this episode of Targeted Talks, two researchers look at what broad racial and ethnic categories obscure in breast cancer research, and what it would take to see more clearly.

First, Scarlett Lin Gomez, PhD, MPH, professor of epidemiology and biostatistics at the University of California, San Francisco, discusses a large study of survival among Asian American women with breast cancer. Her team confirmed that most of the larger Asian American ethnic groups had better survival than non-Hispanic white women. They then adjusted for clinical, treatment, lifestyle, and neighborhood factors, and the advantage persisted. She explains why the group is far from uniform, with some 30 ethnic groups and about 100 languages and dialects, and why patterns by birthplace differed from group to group. The results are not ready to change practice guidelines, she says, but clinicians should know the variation exists.

Next, Evanthia Roussos Torres, MD, PhD, assistant professor of medicine in the Division of Oncology at the University of Southern California, explains why Hispanic patients are rarely enrolled in breast cancer trials, and what that leaves unanswered. She describes how researchers can define the group beyond self-reported ethnicity, using ancestry genome arrays alongside surveys of where patients and their families come from. She also outlines her lab’s work on suppressive myeloid cells in breast tumors, why breast cancer has responded only modestly to checkpoint inhibitors, and her biggest open question: how much of that suppression must be overcome. Whether ancestry shapes immune response is still unknown, she stresses, and answering it will take time and more patients taking part in research.

Both guests make the same point from different angles: better questions require better data, and better data requires the patients to be seen. Listen for what each researcher would change next.