# Ethnicity and outcome of young breast cancer patients in the United Kingdom: the POSH study

Source: https://onco.cc/key-papers/paper-copson-posh-ethnicity-young-breast-cancer-uk-bjc-2014/  
OnCo record `paper-copson-posh-ethnicity-young-breast-cancer-uk-bjc-2014` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The UK cohort of 2,915 women diagnosed with breast cancer at 40 or younger in which Black women had more triple-negative tumours (26 versus 19 percent) and worse survival despite the same access to care and the same use of chemotherapy.

## Summary

Copson, Maishman, Gerty, Eccles and colleagues compared tumour pathology, treatment and outcome across ethnic groups in the POSH national cohort of women aged 40 or under at breast cancer diagnosis. Ethnicity was available for 2,915 patients: 2,690 (91.0 percent) White, 118 (4.0 percent) Black and 87 (2.9 percent) Asian. Median tumour diameter was larger in Black than White women (26.0 versus 22.0 mm, p=0.0103) and multifocal tumours more frequent in Black (43.4 percent) and Asian (37.0 percent) than White women (28.9 percent). Triple-negative tumours were more frequent in Black (26.1 percent) than White women (18.6 percent, p=0.043). Chemotherapy use was equally high (89, 88.6 and 89.7 percent). Five-year distant relapse-free survival was lower in Black women (62.8 percent) than Asian (77.0 percent, p=0.0473) or White women (77.0 percent, p=0.0053), and five-year overall survival 71.1 percent (95 percent CI 61.0 to 79.1) versus 82.4 percent (80.8 to 83.9) for White women (p=0.0160). In multivariate analysis Black ethnicity independently affected distant relapse-free survival in oestrogen receptor-positive disease (hazard ratio 1.60, 1.03 to 2.47).

## Fields

- Kind: Key paper
- Last checked: 2026-09-24
- Tags: tnbc-evidence
- Journal: British Journal of Cancer
- Year: 2014
- DOI: 10.1038/bjc.2013.650
- Authors: Copson E, Maishman T, Gerty S, et al.
- Findings: Triple-negative tumours in 26.1 percent of Black vs 18.6 percent of White women under 41 (p=0.043).; Five-year overall survival 71.1 vs 82.4 percent for Black vs White women (p=0.0160); chemotherapy use equal at about 89 percent.; Black ethnicity an independent risk factor for distant relapse in oestrogen receptor-positive disease (hazard ratio 1.60).
- What it means: The UK's own evidence that the disparity is not only American and not only about access: within the NHS, with equal chemotherapy use, young Black women had more triple-negative disease and worse survival. It anchors the disparities idea on the triple-negative page and the UK and NHS page.
- Caveats: Only 118 Black and 87 Asian women; ethnicity self-reported and grouped broadly.; Cohort restricted to women aged 40 or under.

## Sources

- Br J Cancer 2014: https://doi.org/10.1038/bjc.2013.650
- PubMed: https://pubmed.ncbi.nlm.nih.gov/24149174/

## Connected records

- key papers: [Race, breast cancer subtypes, and survival in the Carolina Breast Cancer Study](https://onco.cc/key-papers/paper-carey-race-breast-cancer-subtypes-cbcs-jama-2006/)
- cancers: [HR-positive / HER2-negative breast cancer](https://onco.cc/cancers/breast-hr-positive/), [Triple-negative breast cancer (TNBC)](https://onco.cc/cancers/tnbc/)
- institutions: [Cancer Research UK](https://onco.cc/institutions/cruk/)
- bottlenecks: [Fragmented care and guideline gaps](https://onco.cc/bottlenecks/b-care-fragmentation/), [Trials do not represent the people who get cancer](https://onco.cc/bottlenecks/b-trial-diversity/)
- journals: [British Journal of Cancer](https://onco.cc/journals/british-journal-of-cancer/)
- roadmaps: [Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem](https://onco.cc/roadmaps/tnbc-roadmap/)
- ideas: [A UK audit of trial access and germline testing uptake in triple-negative breast cancer](https://onco.cc/ideas/idea-tnbc-uk-trial-access-and-germline-testing-audit/), [Close the gap between who gets triple-negative breast cancer and who is in its trials](https://onco.cc/ideas/idea-tnbc-disparities-in-access-and-outcomes/), [Ethnicity-stratified outcome reporting for triple-negative breast cancer in NHS cancer statistics](https://onco.cc/ideas/idea-tnbc-uk-ethnicity-stratified-outcome-reporting/)

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