Using a multimodal approach to elucidate racial disparities in breast cancer biology by integrating tumor imaging and -omics data


Background: Race-related differences in breast cancer incidence and clinical outcome have been well documented, with many studies focusing on socioeconomic determinants contributing to African American (AA) breast cancer patients having higher mortality rates. Far less is understood about the underlying biological differences in tumors between AA and Caucasian patients. In recent years, there have been more and more individual accounts identifying specific somatic mutations or observed breast tumor behaviors associated with racial disparities in breast cancer. Understanding how these specific observations coincide to give rise to alternative tumor biology in AA women, remains a challenge. Given the multifactorial nature of cancer, we have developed a platform that integrates the combinatorial phenotypic, molecular, and biological hallmarks of cancer. Our technology combines imaging and multi-omics data, providing a systematic approach for understanding race-specific biological differences and how they contribute to patient survival.

Methods: Imaging and transcriptomic data from 1108 patients were integrated within the SimBioSys TumoScope biophysical modeling software to understand racial differences in tumor biology, coordinated tumor behavior, and corresponding patient outcome.

Results: AA patients have tumors that display higher growth rates, characteristically have higher adipose tissue around the tumor, higher spatial variation in drug/ nutrient delivery, and increased tumor stiffness. We also identified biological features, including tumor/gland density and intertumoral heterogeneity that are prognostic for overall survival even when accounting for race and cancer subtype.

Conclusion: Our results outline characteristic biological features that along with race and FDA breast cancer subtype may promote the disproportionately poor survival rates observed in AA breast cancer patients. This is the first study demonstrating a systematic approach being used to elucidate race-specific biological difference that may coordinate to impact patient survival.

Our findings emphasize the importance of accounting for racial disparities and patient-specific biology to develop tailored intervention strategies and personalize race-specific clinical management of breast cancer.

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