Black women prone to aggressive breast cancer
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African-American women who haven’t entered menopause but who develop breast cancer have a higher risk of dying from the disease than their white counterparts. Now, new research suggests that this increased risk may be in part due to the higher rate of so-called basal-like breast tumors among premenopausal African-American women.
“Basal-like cancers,” Dr. Lisa A. Carey explained in an interview with Reuters Health, “are highly proliferative, have a lot of ... features of aggressive tumors, and tend to have a poor prognosis.”
Carey is an oncologist at the University of North Carolina-Lineberger Comprehensive Cancer Center in Chapel Hill and is lead author of a report published in this week’s Journal of the American Medical Association.
To investigate the relationship between race, survival and breast cancer subtypes, Carey and her associates studied breast cancer tissue from women enrolled in the Carolina Breast Cancer Study.
Included were 496 women diagnosed with breast cancer between 1993 and 1996 who had available tissue samples. There were 97 premenopausal and 99 postmenopausal African-American women; and 164 premenopausal and 136 postmenopausal non-African-American women.
The investigators found that 30 percent of premenopausal African-American women had basal-like tumors, compared with 14 percent of postmenopausal African-American women. Among the non-African Americans, 16 percent of both premenopausal and postmenopausal women had basal-like tumors.
“This subtype is the only one for which there is no targeted therapy, so our only treatment option is chemotherapy,” Carey explained. However, if the cancer is caught early enough, chemotherapy is quite effective for these tumors, she added. “It’s just that we have to be more aggressive with chemotherapy drugs.”
But she remains hopeful that “five years from now we’ll be talking about targeted therapies for this type of cancer as well,” she stated. “It will be wonderful.”
During follow-up ranging from 8 to 11 years, survival rates were 74 percent among African-American women and 84 percent among non-African-American women. However, the researchers found that when they removed cases of basal-like tumors from their analysis, survival was still significantly different among the different groups.
“So an increased proportion of basal-like tumors is just one piece of the puzzle,” Carey said. “It is clear that (black women’s) worse prognosis is also related to such issues as access to care and early detection.”
SOURCE: Journal of the American Medical Association, June 7, 2006.
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