Young black women have more aggressive breast cancers than white women
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《英国医生杂志》
Breast tumours grow faster and are more aggressive in young black women than young white women, says new US research.
For various social, economic, and cultural reasons breast cancer in African American women is diagnosed at a later stage than in white women, and African American women have poorer survival rates.
Tumours from 124 African American women and 397 white women aged 20 to 54 years in Atlanta, Georgia, were examined for the full array of proteins that control how quickly a cancer cell divides (Cancer 2004;100:2533-42).
Nearly one in five of the black women had cancer that was in stage III or higher, compared with only one in eight white women. Black women were also five times more likely to have high grade, aggressive tumours than white women.
"We looked at markers as they relate to race and to the kind of tumour these women presented with," said Dr Peggy Porter, one of the authors and a pathologist at the Fred Hutchinson Cancer Research Center, Seattle, who reviewed all the tumour specimens but without knowing the race of the participants and the clinical outcomes.
"The odds of a breast carcinoma diagnosis at a younger age and at a later stage were higher for African American women than for white women," write the authors. After taking account of stage of disease and age at diagnosis, the authors also found that black women were more likely than white women to have a higher grade tumour, a higher mitotic index, substantial tumour necrosis, ductal disease, and loss of oestrogen and progesterone receptors.
Black women were four times more likely than white women to have a high concentration of cyclin E, a factor that is associated with poorer survival. High concentrations of cyclin D are associated with better survival, but African American women were only half as likely to have high cyclin D concentrations as white women, the research showed.
"African American women have a higher incidence of breast cancer than white women under age 45; after 45 white women have a higher incidence of breast cancer. No one knows why," Dr Porter told the BMJ. She urged young African American women to be screened for breast cancer.
Dr Porter said that early child bearing might protect against the development of breast cancer after the menopause but not against breast cancer before the menopause. "The question is whether many pregnancies, and therefore extended periods of high hormone levels at a relatively young age, increase the risk for onset of cancer with aggressive characteristics," she said.
She and her colleagues from the Centers for Disease Control and Prevention are now analysing data on the reproductive history of the women in the study.(New York Janice Hopkins T)
For various social, economic, and cultural reasons breast cancer in African American women is diagnosed at a later stage than in white women, and African American women have poorer survival rates.
Tumours from 124 African American women and 397 white women aged 20 to 54 years in Atlanta, Georgia, were examined for the full array of proteins that control how quickly a cancer cell divides (Cancer 2004;100:2533-42).
Nearly one in five of the black women had cancer that was in stage III or higher, compared with only one in eight white women. Black women were also five times more likely to have high grade, aggressive tumours than white women.
"We looked at markers as they relate to race and to the kind of tumour these women presented with," said Dr Peggy Porter, one of the authors and a pathologist at the Fred Hutchinson Cancer Research Center, Seattle, who reviewed all the tumour specimens but without knowing the race of the participants and the clinical outcomes.
"The odds of a breast carcinoma diagnosis at a younger age and at a later stage were higher for African American women than for white women," write the authors. After taking account of stage of disease and age at diagnosis, the authors also found that black women were more likely than white women to have a higher grade tumour, a higher mitotic index, substantial tumour necrosis, ductal disease, and loss of oestrogen and progesterone receptors.
Black women were four times more likely than white women to have a high concentration of cyclin E, a factor that is associated with poorer survival. High concentrations of cyclin D are associated with better survival, but African American women were only half as likely to have high cyclin D concentrations as white women, the research showed.
"African American women have a higher incidence of breast cancer than white women under age 45; after 45 white women have a higher incidence of breast cancer. No one knows why," Dr Porter told the BMJ. She urged young African American women to be screened for breast cancer.
Dr Porter said that early child bearing might protect against the development of breast cancer after the menopause but not against breast cancer before the menopause. "The question is whether many pregnancies, and therefore extended periods of high hormone levels at a relatively young age, increase the risk for onset of cancer with aggressive characteristics," she said.
She and her colleagues from the Centers for Disease Control and Prevention are now analysing data on the reproductive history of the women in the study.(New York Janice Hopkins T)