Breast Cancer: Does Race Play a Role?
Breast cancer affects women of all races and ethnic groups, but researchers are beginning to identify possible genetic differences in who gets cancer and which type they develop. For example, women of Ashkenazi (European) Jewish descent are five times likelier to have an altered BRCA1 or BRCA2 breast cancer gene than other Americans. African-American women have about 10 percent less breast cancer overall than Caucasian women but a higher mortality rate.
A population-based study drawn from the California Cancer Registry of some 50,000 women found that black women are likelier to get an aggressive type of breast cancer known as triple-negative -- nearly 25 percent had it compared with 11 percent of whites, 12 percent of Asians, and 17 percent of Hispanics.
Young black women are especially vulnerable to triple-negative breast tumors. In 2006 researchers at the University of North Carolina at Chapel Hill reported that 39 percent of premenopausal black women with breast cancer had triple-negative tumors compared with 14 percent of postmenopausal black women and 16 percent of non-black women of any age. Result? Their breast cancer tends to spread faster, be more advanced when diagnosed, and have worse prognoses than in white women or older black women. Mortality is 77 percent higher among black women under 50 than for white women the same age.
Black women of all ages are also likelier to have estrogen-receptor-negative tumors (38 percent) than white women (21 percent).
At present these two types of breast cancer are the hardest to treat. Targeted therapies, such as tamoxifen, which have raised survival rates for many women, don't work against them, notes Lisa A. Newman, MD, surgical oncologist and director of the University of Michigan Breast Care Center. Doctors can use surgery, chemotherapy, and radiation, however.
The high African-American mortality rate may also be due to reduced access to good health insurance and thus fewer routine mammograms and less access to the latest cancer treatments. Dr. Newman stresses vigilance: "Early detection of breast cancer is important no matter your racial or ethnic background."
For more information contact the Sisters Network, Inc. (www.sistersnetworkinc.org or 1-866-781-1808). It provides educational outreach, support, and advocacy for addressing the devastating impact that breast cancer has in the African-American community.
Originally published in Ladies' Home Journal, August 2008.