ICYMI: Highlights From SABCS 2023

At the 2023 San Antonino Breast Cancer Symposium (SABCS), 3 of our top 5 conference articles examined findings from research meant to close the health care equity gap among several marginalized and underrepresented patient populations in the breast cancer space. The remaining highlights provided a trial update on fertility preservation outcomes in women who paused endocrine therapy to attempt pregnancy and outcomes among patients with benign breast disease (BBD).

These are your SABCS highlights, and click here for all of our coverage from the conference.

5. SDOH in Cancer Care Highlight Multifactorial Equity Issues

A trio of speakers sought to answer questions on social determinants of health (SDOH) and why they are important, multilevel barriers to addressing social risks, and optimizing use of SDOH data to overcame care equity gaps in cancer care. Their analyses examined such factors as residential ZIP code, financial stress, downstream health effects, and receipt of non–guideline-concordant care. “Health disparity is a multifactorial issue. We know there are contributions from the environmental, social, cultural, psychological, clinical, biological, genetic, and the behavioral spaces,” one speaker expressed. “Anybody who wants to intervene on any of these disparate outcomes can not only just address one of these factors, but must address multiple factors.”

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4. Refining Precision Prevention for Benign Breast Disease

Many questions remain on breast cancer risk among patients with lower-risk–classified diseases, such as nonproliferative lesions and proliferative changes (or lesions) without atypia (PWoA), in stark contrast to the higher-risk categories of atypical ductal and lobular hyperplasia and lobular carcinoma in situ, according to this research conducted as part of a doctoral dissertation. These data show that at all levels of breast density, women who have a PWoA BBD diagnosis have an elevated breast cancer risk, demonstrating a need for more refined precision prevention in these patients.

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3. Race/Ethnicity May Influence Local Recurrence in DCIS, Adjuvant Treatment

This analysis found significantly higher rates of 10-year local recurrence (LR) of ductal carcinoma in situ (DCIS) among Black women vs Asian, Hispanic, and White women treated at Memorial Sloan Kettering Cancer Center between 1978 and 2016. A 48% higher risk of LR was seen among the Black women compared with 29% among Asian women and 7% among Hispanic women after multivariate analysis, and univariate analysis showed elevated risks of 43% and 8% among Black and Asian women, respectively, but a 23% reduced risk among Asian women. No associations were seen with family history, grade, necrosis, or number of excisions.

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2. POSITIVE Trial Update on Patients With Breast Cancer Attempting Pregnancy

This update encompassed data on the POSITIVE trial’s secondary outcomes of menstruation and use of assisted reproductive technology (ART) among women who paused endocrine therapy for breast cancer for a maximum of 2 years to attempt pregnancy. Seventy-four percent of the women enrolled reported at least 1 pregnancy, and 94% who reported amenorrhea at enrollment restarted their periods during the study. Among the 497 women included in the fertility/ART analysis, at diagnosis, 51% underwent fertility preservation and 43%, ART.

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1. New Insights on Breast Cancer Outcomes Among Sexual, Gender Minorities

Two posters presented at SABCS this year aimed to close an information gap on breast cancer outcomes among individuals who identify as a sexual or gender minority. Research shows that these patient populations could have higher rates of disease recurrence vs cisgender individuals. One poster contained data from an ongoing pilot study at Medical College of Wisconsin of future breast cancer risk among transgender and gender-diverse individuals assigned female or intersex at birth undergoing chest masculinization surgery, and the second poster used data from the National Institutes of Health All of Us Database to evaluate disease risk among women who identify as bisexual or lesbian.

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