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Breast cancer in African America women

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Breast cancer news 3/14/2005

    Clinical presentation and course of breast cancer in African
    American population here in the United States may have close resemblance to the breast cancer in presentation and features that occur in Africans as per a new study published in April 15th issue of Cancer. This suggests that genetic factors may be playing significant role in the clinical presentation and course of breast cancer in African Americans and may also explain the racial differences seen between the Caucasians and African Americans. This study also observes that as Africans are getting more westernized the potential for breast cancer increases in African women.

    Studies have shown that while African American women have lower rates of breast cancer than white women in the United States, they have poorer outcomes. African American women are more likely to develop breast cancer at a younger age compared to the Caucasian population. Among women in the U.S. under the age of 45, African Americans have the highest incidence of breast cancer. African Americans are also more likely to be diagnosed with higher stage disease meaning that the cancer is diagnosed more late in the course of the disease. This clinical pattern is similar to that identified in the Ashkenazi populations that led to the discovery of BRCA-1 and -2 gene mutations, prompting many scientists to believe that there may also be a genetic component contributing to breast cancer in African Americans and there may be presence of BRCA like genes in African Americans.

    Alero Fregene, M.D. and Lisa A. Newman, M.D., M.P.H. of the University of Michigan in this study showed tumor biology, genetics, and inheritance patterns, does demonstrate epidemiological and clinical similarities between Africans and African Americans. African women are diagnosed most often between 35 and 45 years, and more than fifteen years earlier than women in Europe and North America. The mortality rate seen among women in sub-Saharan Africa is disproportionately high compared to the incident rate, as in African American women. Their tumors tend to be very aggressive with short periods of time between the onset of symptoms and diagnosis. Moreover, the tumors at diagnosis also tend to be higher grade, often involving axillary lymph nodes and, therefore, higher stages disease with worse prognoses. Poor prognosis is compounded by resource poor healthcare infrastructure, which offers limited treatment options and underutilizes effective treatments.

    Still, the incidence of breast cancer in sub-Saharan Africa is small at 20 per 100,000 compared to 90 per 100,000 people in the West. The reason for this geographic disparity has much to do with protective behaviors that inadvertently minimize estrogen exposure, such as reproductive patterns, body build, and dietary patterns. The authors say as Africans adopt Western lifestyles, these protective behaviors are expected to be replaced with known risk factors for breast cancer.

    The authors conclude, that the parallels between African American and Sub-Saharan African breast cancer patients suggests the possible effects of hereditary factors, and these influences may cause the younger age distribution that is seen among these patient populations to persist.

    Based on: "Breast Cancer in Sub-Saharan Africa: How Does It Relate to Breast Cancer in African-American Women?," Alero Fregene, Lisa A. Newman, CANCER; Published Online: March 14, 2005 (DOI: 10.1002/cncr.20978); Print Issue Date: April 15, 2005.