Abstract Ductal carcinoma in situ (DCIS) is a non-obligate precursor to invasive breast cancer (IBC). Studies have indicated differences in DCIS outcome based on race or ethnicity, but molecular differences have not been investigated. We examined the molecular profile of DCIS by self-reported race (SRR) and outcome groups in Black (n=99) and White (n=191) women with DCIS in a large DCIS case-control cohort with longitudinal follow up. Gene expression and pathway analyses indicated that different genes and pathways are involved in ipsilateral breast outcome (DCIS or IBC) after DCIS treatment in White versus Black women. We identified differences in ER and HER2 expression, tumor microenvironment composition, and copy number variations by SRR and outcome groups. Our results suggest that different molecular mechanisms drive subsequent ipsilateral breast events in Black versus White women.
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