Higher Mortality Rate Among Black Women With Breast Cancer Could Be Explained By Type Of Tumor, Study Says

Main Category: Breast Cancer
Article Date: 10 Jun 2006 - 9:00 PDT

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Premenopausal black women are more than twice as likely as white women or postmenopausal black women to develop a more aggressive, "basal-like" subtype of breast cancer with genetic traits that make it difficult to treat, according to a study published in the June 7 edition of the Journal of the American Medical Association, the Long Island Newsday reports (Talan, Long Island Newsday, 6/7). Basal-like tumors -- which women with genetic mutations called BRCA1 tend to develop -- usually grow rapidly, spread quickly and are more likely to be fatal than other subtypes of breast cancer tumors, according to the New York Times. The tumors are not fueled by estrogen, so they cannot be treated with estrogen-blocking drugs, such as tamoxifen or raloxifene, and the breast cancer drug Herceptin also is ineffective. Chemotherapy can be used as a treatment for basal-like tumors but even with the treatment, women with basal-like tumors are less likely than other women to survive. For the study, Lisa Carey, medical director of the University of North Carolina-Lineberger Comprehensive Cancer Center, and colleagues at the University of North Carolina-Chapel Hill examined stored tissue samples from 496 women who were diagnosed with breast cancer from 1993 to 1996 and who were included in a project called the Carolina Breast Cancer Study. The women had an average age of 50, and 40% of them self-identified as black. The researchers recorded patterns of gene activity in the cancer cells to classify the subtype of the tumors and then separated the subtypes by race, menopausal status, other tumor characteristics and survival rate. The study is the first to calculate the prevalence of various subtypes of breast cancer tumors in American women and to sort the subtypes by race, according to the Times. The study says that 39% of premenopausal black women with breast cancer had a basal-like breast cancer tumor, compared with 14% of postmenopausal black women and 16% of women at any age who were not black. The study helps explain why black women, especially those younger than age 50, are more likely to die from breast cancer than white women even though the disease is less prevalent in blacks, according to the Times. The mortality rate of black women who develop breast cancer, particularly under age 50, is 11 deaths per 100,000 women, compared with 6.3 per 100,000 for white women, the Times reports. The findings will not affect current courses of treatment because there is no known treatment to specifically target basal-like tumors, the Times reports. Carey said more research is needed to confirm the study's findings (Grady, New York Times, 6/7).

The study is available online.

Disparities Between Blacks, Whites Play Role in Black Breast Cancer Mortality, Study Says
Disparities in treatment is a contributing factor in why black women are more likely than white women to die from breast cancer, according to a study presented on Tuesday at the conclusion of a five-day meeting of the American Society of Clinical Oncology in Atlanta, the Atlanta Journal-Constitution reports. William Eley of Emory University's Winship Cancer Institute and colleagues studied 2,437 white women and 877 black women with breast cancer who lived in five metro Atlanta counties. The researchers defined disparities in treatment as "delay in first course treatment; type of treatment; performance of cancer directed surgery; type of surgery; and receipt of chemotherapy, radiotherapy or hormonal therapy." The researchers found that black women are more likely to experience delays in treatment, regardless of whether they have late-stage cancer and are four- to five-times as likely to experience treatment delays of more than 60 days. The study also finds that 61% of black women and 72% of white women received radiation with breast conserving surgery and that black women eligible for hormonal therapy were less likely than white women to receive it. The researchers said that differences in treatment between blacks and whites "could be a major contributing factor to racial disparities in outcome." They concluded that race affects treatment quality and the standards of treatment for women living with breast cancer (Hendrick, Atlanta Journal-Constitution, 6/7).

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