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Comment & Response
June 24, 2021

Racial/Ethnic Differences in the 21-Gene Recurrence Score Assay Among Women With Breast Cancer

Author Affiliations
  • 1Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus
  • 2Comprehensive Cancer Center, University of Michigan, Ann Arbor
JAMA Oncol. 2021;7(8):1247-1248. doi:10.1001/jamaoncol.2021.1953

To the Editor In their cohort study on race/ethnicity, the 21-gene recurrence score, and breast cancer–specific mortality, Hoskins et al1 report an association between Black race and higher disease-specific mortality across recurrence score risk stratum. We commend the authors on this study and believe it makes significant contributions to furthering our understanding of racial disparities in breast cancer outcomes. However, we were surprised by the authors’ decision to not use many of the social determinants of health variables in Surveillance, Epidemiology, and End Results (SEER) program data in their analysis. Studies have shown an association between insurance, neighborhood socioeconomic status, and area of residence (eg, rural or urban) on the diagnosis, treatment, and mortality from breast cancer.2-4 Notably, these variables are all available in some iterations of SEER program data. More importantly, the authors1 never explained the reasons behind omitting these variables in their analysis.

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