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ResearchIn-Press PreviewCell biologyOncology
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Sandeep K. Singhal,1
Jung S. Byun,2
Tingfen Yan,2
Ryan Yancey,3
Ambar Caban,3
Sara Gil Hernandez,2
Sediqua Bufford,4
Stephen M. Hewitt,5
Joy Winfield,3
Jaya Sarin Pradhan,3
Vesco Mustkov,3
Jasmine A. McDonald,6
Eliseo J. Pérez-Stable,2
Anna Maria Napoles,2
Nasreen Vohra,7
Adriana De Siervi,8
Clayton Yates,9
Melissa B. Davis,10
Mei Yang,11
Yien Che Tsai,11
Allan M. Weissman,11 and
Kevin Gardner3
1Department of Pathology, University of North Dakota, Grand Forks, United States of America
2Intramural Research Program, National Institutes of Minority Health and Health Disparities, Bethesda, United States of America
3Department of Pathology and Cell Biology, Columbia University Medical Center, New York, United States of America
4Masters of Science Biotechnology, Morehouse School of Medicine, Atlanta, United States of America
5Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, United States of America
6Department of Epidemiology, Columbia University Medical Center, New York, United States of America
7Brody School of Medicine, East Carolina University, Greenville, United States of America
8Directora del Laboratorio de Oncología Molecular y Nuevos Blancos Terapéut, CONICET, Buenos Aiers, Argentina
9Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, United States of America
10Department of Surgery (Breast Surgery & Oncology), Weill Cornell Medicine, New York, United States of America
11Laboratory of Protein Dynamics and Signaling, National Cancer Institute, Frederick, United States of America
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1Department of Pathology, University of North Dakota, Grand Forks, United States of America
2Intramural Research Program, National Institutes of Minority Health and Health Disparities, Bethesda, United States of America
3Department of Pathology and Cell Biology, Columbia University Medical Center, New York, United States of America
4Masters of Science Biotechnology, Morehouse School of Medicine, Atlanta, United States of America
5Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, United States of America
6Department of Epidemiology, Columbia University Medical Center, New York, United States of America
7Brody School of Medicine, East Carolina University, Greenville, United States of America
8Directora del Laboratorio de Oncología Molecular y Nuevos Blancos Terapéut, CONICET, Buenos Aiers, Argentina
9Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, United States of America
10Department of Surgery (Breast Surgery & Oncology), Weill Cornell Medicine, New York, United States of America
11Laboratory of Protein Dynamics and Signaling, National Cancer Institute, Frederick, United States of America
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Byun, J.
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1Department of Pathology, University of North Dakota, Grand Forks, United States of America
2Intramural Research Program, National Institutes of Minority Health and Health Disparities, Bethesda, United States of America
3Department of Pathology and Cell Biology, Columbia University Medical Center, New York, United States of America
4Masters of Science Biotechnology, Morehouse School of Medicine, Atlanta, United States of America
5Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, United States of America
6Department of Epidemiology, Columbia University Medical Center, New York, United States of America
7Brody School of Medicine, East Carolina University, Greenville, United States of America
8Directora del Laboratorio de Oncología Molecular y Nuevos Blancos Terapéut, CONICET, Buenos Aiers, Argentina
9Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, United States of America
10Department of Surgery (Breast Surgery & Oncology), Weill Cornell Medicine, New York, United States of America
11Laboratory of Protein Dynamics and Signaling, National Cancer Institute, Frederick, United States of America
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Yan, T.
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1Department of Pathology, University of North Dakota, Grand Forks, United States of America
2Intramural Research Program, National Institutes of Minority Health and Health Disparities, Bethesda, United States of America
3Department of Pathology and Cell Biology, Columbia University Medical Center, New York, United States of America
4Masters of Science Biotechnology, Morehouse School of Medicine, Atlanta, United States of America
5Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, United States of America
6Department of Epidemiology, Columbia University Medical Center, New York, United States of America
7Brody School of Medicine, East Carolina University, Greenville, United States of America
8Directora del Laboratorio de Oncología Molecular y Nuevos Blancos Terapéut, CONICET, Buenos Aiers, Argentina
9Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, United States of America
10Department of Surgery (Breast Surgery & Oncology), Weill Cornell Medicine, New York, United States of America
11Laboratory of Protein Dynamics and Signaling, National Cancer Institute, Frederick, United States of America
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Yancey, R.
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1Department of Pathology, University of North Dakota, Grand Forks, United States of America
2Intramural Research Program, National Institutes of Minority Health and Health Disparities, Bethesda, United States of America
3Department of Pathology and Cell Biology, Columbia University Medical Center, New York, United States of America
4Masters of Science Biotechnology, Morehouse School of Medicine, Atlanta, United States of America
5Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, United States of America
6Department of Epidemiology, Columbia University Medical Center, New York, United States of America
7Brody School of Medicine, East Carolina University, Greenville, United States of America
8Directora del Laboratorio de Oncología Molecular y Nuevos Blancos Terapéut, CONICET, Buenos Aiers, Argentina
9Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, United States of America
10Department of Surgery (Breast Surgery & Oncology), Weill Cornell Medicine, New York, United States of America
11Laboratory of Protein Dynamics and Signaling, National Cancer Institute, Frederick, United States of America
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Caban, A.
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1Department of Pathology, University of North Dakota, Grand Forks, United States of America
2Intramural Research Program, National Institutes of Minority Health and Health Disparities, Bethesda, United States of America
3Department of Pathology and Cell Biology, Columbia University Medical Center, New York, United States of America
4Masters of Science Biotechnology, Morehouse School of Medicine, Atlanta, United States of America
5Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, United States of America
6Department of Epidemiology, Columbia University Medical Center, New York, United States of America
7Brody School of Medicine, East Carolina University, Greenville, United States of America
8Directora del Laboratorio de Oncología Molecular y Nuevos Blancos Terapéut, CONICET, Buenos Aiers, Argentina
9Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, United States of America
10Department of Surgery (Breast Surgery & Oncology), Weill Cornell Medicine, New York, United States of America
11Laboratory of Protein Dynamics and Signaling, National Cancer Institute, Frederick, United States of America
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Gil Hernandez, S.
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1Department of Pathology, University of North Dakota, Grand Forks, United States of America
2Intramural Research Program, National Institutes of Minority Health and Health Disparities, Bethesda, United States of America
3Department of Pathology and Cell Biology, Columbia University Medical Center, New York, United States of America
4Masters of Science Biotechnology, Morehouse School of Medicine, Atlanta, United States of America
5Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, United States of America
6Department of Epidemiology, Columbia University Medical Center, New York, United States of America
7Brody School of Medicine, East Carolina University, Greenville, United States of America
8Directora del Laboratorio de Oncología Molecular y Nuevos Blancos Terapéut, CONICET, Buenos Aiers, Argentina
9Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, United States of America
10Department of Surgery (Breast Surgery & Oncology), Weill Cornell Medicine, New York, United States of America
11Laboratory of Protein Dynamics and Signaling, National Cancer Institute, Frederick, United States of America
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Bufford, S.
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1Department of Pathology, University of North Dakota, Grand Forks, United States of America
2Intramural Research Program, National Institutes of Minority Health and Health Disparities, Bethesda, United States of America
3Department of Pathology and Cell Biology, Columbia University Medical Center, New York, United States of America
4Masters of Science Biotechnology, Morehouse School of Medicine, Atlanta, United States of America
5Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, United States of America
6Department of Epidemiology, Columbia University Medical Center, New York, United States of America
7Brody School of Medicine, East Carolina University, Greenville, United States of America
8Directora del Laboratorio de Oncología Molecular y Nuevos Blancos Terapéut, CONICET, Buenos Aiers, Argentina
9Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, United States of America
10Department of Surgery (Breast Surgery & Oncology), Weill Cornell Medicine, New York, United States of America
11Laboratory of Protein Dynamics and Signaling, National Cancer Institute, Frederick, United States of America
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Hewitt, S.
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1Department of Pathology, University of North Dakota, Grand Forks, United States of America
2Intramural Research Program, National Institutes of Minority Health and Health Disparities, Bethesda, United States of America
3Department of Pathology and Cell Biology, Columbia University Medical Center, New York, United States of America
4Masters of Science Biotechnology, Morehouse School of Medicine, Atlanta, United States of America
5Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, United States of America
6Department of Epidemiology, Columbia University Medical Center, New York, United States of America
7Brody School of Medicine, East Carolina University, Greenville, United States of America
8Directora del Laboratorio de Oncología Molecular y Nuevos Blancos Terapéut, CONICET, Buenos Aiers, Argentina
9Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, United States of America
10Department of Surgery (Breast Surgery & Oncology), Weill Cornell Medicine, New York, United States of America
11Laboratory of Protein Dynamics and Signaling, National Cancer Institute, Frederick, United States of America
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Winfield, J.
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1Department of Pathology, University of North Dakota, Grand Forks, United States of America
2Intramural Research Program, National Institutes of Minority Health and Health Disparities, Bethesda, United States of America
3Department of Pathology and Cell Biology, Columbia University Medical Center, New York, United States of America
4Masters of Science Biotechnology, Morehouse School of Medicine, Atlanta, United States of America
5Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, United States of America
6Department of Epidemiology, Columbia University Medical Center, New York, United States of America
7Brody School of Medicine, East Carolina University, Greenville, United States of America
8Directora del Laboratorio de Oncología Molecular y Nuevos Blancos Terapéut, CONICET, Buenos Aiers, Argentina
9Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, United States of America
10Department of Surgery (Breast Surgery & Oncology), Weill Cornell Medicine, New York, United States of America
11Laboratory of Protein Dynamics and Signaling, National Cancer Institute, Frederick, United States of America
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Pradhan, J.
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1Department of Pathology, University of North Dakota, Grand Forks, United States of America
2Intramural Research Program, National Institutes of Minority Health and Health Disparities, Bethesda, United States of America
3Department of Pathology and Cell Biology, Columbia University Medical Center, New York, United States of America
4Masters of Science Biotechnology, Morehouse School of Medicine, Atlanta, United States of America
5Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, United States of America
6Department of Epidemiology, Columbia University Medical Center, New York, United States of America
7Brody School of Medicine, East Carolina University, Greenville, United States of America
8Directora del Laboratorio de Oncología Molecular y Nuevos Blancos Terapéut, CONICET, Buenos Aiers, Argentina
9Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, United States of America
10Department of Surgery (Breast Surgery & Oncology), Weill Cornell Medicine, New York, United States of America
11Laboratory of Protein Dynamics and Signaling, National Cancer Institute, Frederick, United States of America
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Mustkov, V.
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1Department of Pathology, University of North Dakota, Grand Forks, United States of America
2Intramural Research Program, National Institutes of Minority Health and Health Disparities, Bethesda, United States of America
3Department of Pathology and Cell Biology, Columbia University Medical Center, New York, United States of America
4Masters of Science Biotechnology, Morehouse School of Medicine, Atlanta, United States of America
5Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, United States of America
6Department of Epidemiology, Columbia University Medical Center, New York, United States of America
7Brody School of Medicine, East Carolina University, Greenville, United States of America
8Directora del Laboratorio de Oncología Molecular y Nuevos Blancos Terapéut, CONICET, Buenos Aiers, Argentina
9Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, United States of America
10Department of Surgery (Breast Surgery & Oncology), Weill Cornell Medicine, New York, United States of America
11Laboratory of Protein Dynamics and Signaling, National Cancer Institute, Frederick, United States of America
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McDonald, J.
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1Department of Pathology, University of North Dakota, Grand Forks, United States of America
2Intramural Research Program, National Institutes of Minority Health and Health Disparities, Bethesda, United States of America
3Department of Pathology and Cell Biology, Columbia University Medical Center, New York, United States of America
4Masters of Science Biotechnology, Morehouse School of Medicine, Atlanta, United States of America
5Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, United States of America
6Department of Epidemiology, Columbia University Medical Center, New York, United States of America
7Brody School of Medicine, East Carolina University, Greenville, United States of America
8Directora del Laboratorio de Oncología Molecular y Nuevos Blancos Terapéut, CONICET, Buenos Aiers, Argentina
9Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, United States of America
10Department of Surgery (Breast Surgery & Oncology), Weill Cornell Medicine, New York, United States of America
11Laboratory of Protein Dynamics and Signaling, National Cancer Institute, Frederick, United States of America
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1Department of Pathology, University of North Dakota, Grand Forks, United States of America
2Intramural Research Program, National Institutes of Minority Health and Health Disparities, Bethesda, United States of America
3Department of Pathology and Cell Biology, Columbia University Medical Center, New York, United States of America
4Masters of Science Biotechnology, Morehouse School of Medicine, Atlanta, United States of America
5Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, United States of America
6Department of Epidemiology, Columbia University Medical Center, New York, United States of America
7Brody School of Medicine, East Carolina University, Greenville, United States of America
8Directora del Laboratorio de Oncología Molecular y Nuevos Blancos Terapéut, CONICET, Buenos Aiers, Argentina
9Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, United States of America
10Department of Surgery (Breast Surgery & Oncology), Weill Cornell Medicine, New York, United States of America
11Laboratory of Protein Dynamics and Signaling, National Cancer Institute, Frederick, United States of America
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Napoles, A.
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1Department of Pathology, University of North Dakota, Grand Forks, United States of America
2Intramural Research Program, National Institutes of Minority Health and Health Disparities, Bethesda, United States of America
3Department of Pathology and Cell Biology, Columbia University Medical Center, New York, United States of America
4Masters of Science Biotechnology, Morehouse School of Medicine, Atlanta, United States of America
5Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, United States of America
6Department of Epidemiology, Columbia University Medical Center, New York, United States of America
7Brody School of Medicine, East Carolina University, Greenville, United States of America
8Directora del Laboratorio de Oncología Molecular y Nuevos Blancos Terapéut, CONICET, Buenos Aiers, Argentina
9Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, United States of America
10Department of Surgery (Breast Surgery & Oncology), Weill Cornell Medicine, New York, United States of America
11Laboratory of Protein Dynamics and Signaling, National Cancer Institute, Frederick, United States of America
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Vohra, N.
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1Department of Pathology, University of North Dakota, Grand Forks, United States of America
2Intramural Research Program, National Institutes of Minority Health and Health Disparities, Bethesda, United States of America
3Department of Pathology and Cell Biology, Columbia University Medical Center, New York, United States of America
4Masters of Science Biotechnology, Morehouse School of Medicine, Atlanta, United States of America
5Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, United States of America
6Department of Epidemiology, Columbia University Medical Center, New York, United States of America
7Brody School of Medicine, East Carolina University, Greenville, United States of America
8Directora del Laboratorio de Oncología Molecular y Nuevos Blancos Terapéut, CONICET, Buenos Aiers, Argentina
9Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, United States of America
10Department of Surgery (Breast Surgery & Oncology), Weill Cornell Medicine, New York, United States of America
11Laboratory of Protein Dynamics and Signaling, National Cancer Institute, Frederick, United States of America
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De Siervi, A.
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1Department of Pathology, University of North Dakota, Grand Forks, United States of America
2Intramural Research Program, National Institutes of Minority Health and Health Disparities, Bethesda, United States of America
3Department of Pathology and Cell Biology, Columbia University Medical Center, New York, United States of America
4Masters of Science Biotechnology, Morehouse School of Medicine, Atlanta, United States of America
5Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, United States of America
6Department of Epidemiology, Columbia University Medical Center, New York, United States of America
7Brody School of Medicine, East Carolina University, Greenville, United States of America
8Directora del Laboratorio de Oncología Molecular y Nuevos Blancos Terapéut, CONICET, Buenos Aiers, Argentina
9Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, United States of America
10Department of Surgery (Breast Surgery & Oncology), Weill Cornell Medicine, New York, United States of America
11Laboratory of Protein Dynamics and Signaling, National Cancer Institute, Frederick, United States of America
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Yates, C.
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1Department of Pathology, University of North Dakota, Grand Forks, United States of America
2Intramural Research Program, National Institutes of Minority Health and Health Disparities, Bethesda, United States of America
3Department of Pathology and Cell Biology, Columbia University Medical Center, New York, United States of America
4Masters of Science Biotechnology, Morehouse School of Medicine, Atlanta, United States of America
5Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, United States of America
6Department of Epidemiology, Columbia University Medical Center, New York, United States of America
7Brody School of Medicine, East Carolina University, Greenville, United States of America
8Directora del Laboratorio de Oncología Molecular y Nuevos Blancos Terapéut, CONICET, Buenos Aiers, Argentina
9Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, United States of America
10Department of Surgery (Breast Surgery & Oncology), Weill Cornell Medicine, New York, United States of America
11Laboratory of Protein Dynamics and Signaling, National Cancer Institute, Frederick, United States of America
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Davis, M.
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1Department of Pathology, University of North Dakota, Grand Forks, United States of America
2Intramural Research Program, National Institutes of Minority Health and Health Disparities, Bethesda, United States of America
3Department of Pathology and Cell Biology, Columbia University Medical Center, New York, United States of America
4Masters of Science Biotechnology, Morehouse School of Medicine, Atlanta, United States of America
5Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, United States of America
6Department of Epidemiology, Columbia University Medical Center, New York, United States of America
7Brody School of Medicine, East Carolina University, Greenville, United States of America
8Directora del Laboratorio de Oncología Molecular y Nuevos Blancos Terapéut, CONICET, Buenos Aiers, Argentina
9Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, United States of America
10Department of Surgery (Breast Surgery & Oncology), Weill Cornell Medicine, New York, United States of America
11Laboratory of Protein Dynamics and Signaling, National Cancer Institute, Frederick, United States of America
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Yang, M.
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1Department of Pathology, University of North Dakota, Grand Forks, United States of America
2Intramural Research Program, National Institutes of Minority Health and Health Disparities, Bethesda, United States of America
3Department of Pathology and Cell Biology, Columbia University Medical Center, New York, United States of America
4Masters of Science Biotechnology, Morehouse School of Medicine, Atlanta, United States of America
5Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, United States of America
6Department of Epidemiology, Columbia University Medical Center, New York, United States of America
7Brody School of Medicine, East Carolina University, Greenville, United States of America
8Directora del Laboratorio de Oncología Molecular y Nuevos Blancos Terapéut, CONICET, Buenos Aiers, Argentina
9Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, United States of America
10Department of Surgery (Breast Surgery & Oncology), Weill Cornell Medicine, New York, United States of America
11Laboratory of Protein Dynamics and Signaling, National Cancer Institute, Frederick, United States of America
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Tsai, Y.
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1Department of Pathology, University of North Dakota, Grand Forks, United States of America
2Intramural Research Program, National Institutes of Minority Health and Health Disparities, Bethesda, United States of America
3Department of Pathology and Cell Biology, Columbia University Medical Center, New York, United States of America
4Masters of Science Biotechnology, Morehouse School of Medicine, Atlanta, United States of America
5Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, United States of America
6Department of Epidemiology, Columbia University Medical Center, New York, United States of America
7Brody School of Medicine, East Carolina University, Greenville, United States of America
8Directora del Laboratorio de Oncología Molecular y Nuevos Blancos Terapéut, CONICET, Buenos Aiers, Argentina
9Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, United States of America
10Department of Surgery (Breast Surgery & Oncology), Weill Cornell Medicine, New York, United States of America
11Laboratory of Protein Dynamics and Signaling, National Cancer Institute, Frederick, United States of America
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Weissman, A.
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1Department of Pathology, University of North Dakota, Grand Forks, United States of America
2Intramural Research Program, National Institutes of Minority Health and Health Disparities, Bethesda, United States of America
3Department of Pathology and Cell Biology, Columbia University Medical Center, New York, United States of America
4Masters of Science Biotechnology, Morehouse School of Medicine, Atlanta, United States of America
5Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, United States of America
6Department of Epidemiology, Columbia University Medical Center, New York, United States of America
7Brody School of Medicine, East Carolina University, Greenville, United States of America
8Directora del Laboratorio de Oncología Molecular y Nuevos Blancos Terapéut, CONICET, Buenos Aiers, Argentina
9Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, United States of America
10Department of Surgery (Breast Surgery & Oncology), Weill Cornell Medicine, New York, United States of America
11Laboratory of Protein Dynamics and Signaling, National Cancer Institute, Frederick, United States of America
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Published May 31, 2022
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More info
JCI Insight.
https://doi.org/10.1172/jci.insight.157465.
Copyright © 2022, Singhal et al.
This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
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Abstract
Women of African ancestry suffer higher rates of breast cancer mortality compared to all other groups in the United States. Though the precise reasons for these disparities remain unclear, many recent studies have implicated a role for differences in tumor biology. Using an epitope-validated antibody against the endoplasmic reticulum-associated degradation (ERAD) E3 ubiquitin ligase, gp78, we show that elevated levels of gp78 in patient breast cancer cells predict poor survival. Moreover, high levels of gp78 are associated with poor outcomes in both ER-positive and ER-negative tumors, and breast cancers expressing elevated amounts of gp78 protein are enriched in gene expression pathways that influence cell cycle, metabolism, receptor-mediated signaling, and cell stress response pathways. In multivariate analysis adjusted for subtype and grade, gp78 protein is an independent predictor of poor outcomes in women of African ancestry. Furthermore, gene expression signatures, derived from patients stratified by gp78 protein expression, are strong predictors of recurrence and pathological complete response in retrospective clinical trial data and share many common features with gene sets previously identified to be overrepresented in breast cancers based on race. These findings implicate a prominent role for gp78 in tumor progression and offer new insights into our understanding of racial differences in breast cancer outcomes.
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