Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)


Healthcare Genetics

Committee Member

Dr. Julie Eggert, GNP-BC, AGN-BC, AOCN, FAAN

Committee Member

Dr. Jim McDonell, MSW, PhD

Committee Member

Dr. Arelis Moore de Peralta, MD, PhD, MPH, Med

Committee Member

Dr. Paula Watt, PhD, FNP-BC

Committee Member

Dr. Elisabeth Chismark, PhD, RN


A breast tumor with a histology report that lacks Estrogen Receptor, Progesterone Receptor, and Human Epidermal Growth Receptor 2/neu is identified as a Triple Negative Breast Cancer (TNBC). Women with TNBC compared to non-TNBC patients have 50% increased risk for all-cause mortality and TNBC is reported to have poor survival compared to other Breast Cancer sub-types. TNBC is an aggressive disease with varied outcomes among race/ethnicities in the United States. Chapter one is an introduction chapter that introduces the problem statement, highlights the significance of the problem, provides the theoretical framework along with its constructs and how it supports the proposed research. Chapter two is a review of the available published literature on TNBC, its phenotype and genotype, risk factors and ethnic differences among women of color. The literature search covered a span of ten years' articles published in the online journals such as PubMed, CINAHL, Web of Science, and Medline and retrieved selected 85 journal articles. The review also provides information on ethnic similarities and differences for early detection, prevention, and treatment of TNBC. Chapter three is a research article and the purpose of that chapter is to provide the research questions and hypotheses related to specific aim one and two. Specific aim one is to provide the age-adjusted and age-specific incidence rates on TNBC among major races/ethnicities such as Non-Hispanic White, Non-Hispanic Black, Hispanic (all Races), and Asian Pacific Islander. The study sample included all 18 registries of Surveillance Epidemiology, and End Results. The chapter also provides TNBC phenotypic, demographic, and treatment characteristics among TNBC cases and ethnic differences among them. For specific aim two, the sample includes five Asian sub-ethnicities, Chinese, Asian Indian, Vietnamese, Filipina, and Korean women along with Non-Hispanic White, Non-Hispanic Black and Hispanic women. Chapter four discusses the research findings and discussion on TNBC compared to non-TNBC cases, results from a binary regression model to predict TNBC risk among women of color. Odds Ratio for significant variables to predict TNBC risk are presented. Chapter five summarizes the dissertation by providing main findings and discussions. The limitations of the research study are presented and recommendations from the study are discussed. Finally, research implications developed from the study are listed.



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.