Breast cancer is more aggressive in African-American women

African American women are diagnosed with breast cancer at a younger age and have larger tumors and more lymph node involvement than Caucasian women, a Yale School of Medicine researcher reported today.

Speaking at the American Society for Therapeutic Radiology and Oncology meeting in Los Angeles, Meena Moran, M.D., assistant professor of therapeutic radiology and Yale Cancer Center member, said her results were based on 2,164 Caucasian women and 207 African American women followed over a 30-year period—the largest most comprehensive study of its kind to date. All underwent lumpectomies in which the tumor, not the entire breast, was removed.

“The incidence of breast cancer is actually lower in African American women compared to Caucasian women, yet their mortality rates are higher,” Moran said. “We were surprised. Previous reports did not show higher relapse rates in African American women after surgery to conserve breast tissue. This might be because we had so many African American patients and a longer follow-up period.”

She said there are several possible biological risk factors that need to be explored more fully. African American women have a lower level of estrogen/progesterone receptors, which means existing anti-estrogen therapies are not effective on these tumors. African American women have a higher rate of “triple negative tumors,” which have been associated with a worse outcome in early stage breast cancer. They also have a higher rate of mutation in the p53 gene, which normally acts to suppress tumors.

“In terms of outcomes after treatment,” Moran said, “African American patients were found to have a significantly higher rate of relapse in the breast and lymph nodes after breast conservation treatment compared to Caucasians. We did not, however, find any differences in the rate of cancer spreading to other locations such as the lung, bone, or liver, or in the overall survival in the two groups of patients.”

Moran said she hoped that the study would increase awareness of the aggressive nature of breast cancer in African American women. She said this does not mean that African American women should not have lumpectomies. She emphasized that greater attention should be paid to ensure the tumor is completely removed and that follow up radiation therapy is adequate and includes the entire breast and lymph nodes.

“We hope that patients and physicians will help reduce the gap in the disparities between the two populations by improving early detection/screening, better access to care and compliance with chemotherapy and radiation,” Moran said. “These patients can modify their lifestyles to decrease risk factors, such as obesity. There also is a need for African American patients to take part in large breast cancer studies to better understand the ethnicity based differences in breast cancer.”

Source: Yale University

Related stories:

A new gel could help menopausal women with low libidos
Doctors in Hampton Roads, Va., have begun a clinical trial on a new female testosterone gel they hope can help menopausal women who have lost interest in sex.
Want a mammogram? Get in line
Doctors usually recommend that women older than 40 get yearly mammograms. But if you're planning on calling Northwestern Memorial Hospital's state-of-the-art breast imaging center, grab next year's calendar: The next opening is in May.
Second lumpectomy for breast cancer reduces survival rates
A majority of women with breast cancer today are candidates for lumpectomy, allowing for conservation of most of their breast tissue. Results of a UC Davis study, however, show that a number of women whose cancer recurs in the same breast are treated with a second lumpectomy rather than a mastectomy, defying current treatment recommendations and cutting the number of years those women survive in half.
Study looks at psychological impact of gene test for breast cancer
Personal beliefs about inconclusive DNA testing for hereditary breast cancer are associated with cancer-related worry, and such beliefs are an especially strong predictor of whether women had been able to leave the period of DNA-testing behind, reports a study in the October issue of Genetics in Medicine, official journal of the American College of Medical Genetics (ACMG). The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.
Computers help docs spot breast cancer on X-rays
(AP) -- A computer is as good as a second pair of eyes for helping a radiologist spot breast cancer on a mammogram, one of the largest and most rigorous tests of computer-aided detection found.
Core needle breast biopsy safe for patients taking blood thinners
It is safe to take anticoagulants (blood thinners) before core needle breast biopsies, according to a study performed at the Elizabeth Wende Breast Clinic in Rochester, NY. Core needle biopsies are offered as an alternative to surgical biopsy when a tissue sample of an irregular area in the breast is found by mammogram or sonogram. "They are safer than surgical procedures, require fewer anesthetics, and are accurate," according to Patricia Somerville, MD, lead author of the study.
Study shows radiation device may customize therapy, enable some to avoid more lengthy treatment
A study of the first approximately 100 patients who have received partial breast irradiation with a small, whisk-like, expandable device inserted inside the breast has shown that after one year, the device is effective at sparing nearby healthy tissue from the effects of radiation. The device, called SAVI™, is aimed at providing customized radiation therapy while minimizing exposure to healthy tissue around the breast after a woman has received a lumpectomy for early stage cancer.
Young women w/ early form of breast cancer no more likely to experience recurrence than older women
Young women with DCIS, a common form of early breast cancer that arises in and is confined to the mammary ducts, are presumed more likely to have recurrences than older women with the same diagnosis. But a new study from Fox Chase Cancer Center rebuffs this conventional thinking.

News discussion:

Medicine & Health news