Black Women More Likely to Have Breat Cancer

Black women in Britain develop breast cancer up to 21 years earlier than white women. They are seen at a median age of 46—four years before routine NHS screening for the disease starts—compared with 67 for white women, according to the first published data on breast cancer presentation in black women (British Journal of Cancer; doi: 10.1038/sj.bjc.6604174).

Among women with smaller tumours (less than 2 cm), black women were nearly three times as likely to die of their disease (hazard ratio 2.90, 95% CI 0.98 to 8.60, P=0.05).

"Our findings could have major implications for the biology of breast cancer and the detection and treatment of the disease in black women," say the authors. "It is crucial to target this group of women to raise their awareness regarding the risks of breast cancer, the likelihood of early age at presentation, and the importance of self-examination."

The authors, from Barts and The London, Queen Mary's School of Medicine and Dentistry, and Wolfson Institute of Preventive Medicine, say that until now there have been no data on the patterns of breast cancer in British black women.

"Since there are no published data on breast cancer in British black women, we sought to determine whether, like African-American women, they present at a younger age with biologically distinct disease patterns,'' they say.

For the study, the authors looked at women presenting at the Homerton University Hospital, Hackney, between 1994 and 2005 with a diagnosis of invasive breast cancer. Of the 445 patients with a new diagnosis of breast cancer between 1994 and 2005, 102 were black and 191 white British women.

Results show big differences in age at diagnosis. Black patients were significantly younger (median 46 v 67 years, P=0.001). No other common cancer in the same population of black women was as common in younger women.

A higher proportion of black women had grade 3 tumours, lymph node positive disease, negative oestrogen receptor and progesterone receptor status, and basal-like (triple negative status) tumours. Some 62% of black women had grade 3 tumours, compared with 42% of white patients.

The authors say there is no evidence that the results are due to late presentation or inequalities in the receipt of therapy. A data review showed that black women received more adjuvant therapy—chemotherapy, radiotherapy, and hormone therapy—than their white counterparts.

"Breast cancers arising in young black women appear to be biologically different, an effect not attributable simply to the young age of affected individuals," say the authors, who add that while tumours in younger black women are considerably more aggressive, in women over 60, whatever their ethnic origin, breast tumours show similar behaviour.

The authors point out that the NHS breast screening programme is offered to all women up to age 70, starting at 50, four years later than the median age for presentation of the black women in the study.

"Alterations to the screening services offered to black populations might be considered to better reflect the incidence patterns for this group, much as it has been for those individuals with a family history deemed to be at risk of breast cancer at a younger age," says the report. "Additional resources required for the screening of black women from age 40 or 45 would be modest, but there could be organisational difficulties in identifying the relevant population for invitation."

Black Women More Likely to Have Breat Cancer

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2206301/