Background Differences in the breast cancer burden of African American compared with White American women are well-documented. Recent controversies have emerged regarding age-appropriate mammographic screening guidelines, and these surveillance recommendations may influence future breast cancer disparities. Our goal was to evaluate age-specific breast cancer stage distributions and incidence rates of triple-negative breast cancer (TNBC) in a population-based tumor registry. Study Design We analyzed California Cancer Registry (CCR) breast cancers diagnosed 1988 – 2006. Results were stratified by age and race/ethnicity, with White Americans identified as Non-Hispanic Whites (NHW) and African Americans as Non-Hispanic Blacks (NHB). Breast cancer stage distributions and TNBC incidence rates were also analyzed. Results A total of 375,761 invasive breast cancers were evaluated (including 276,938 in NHW and 21,681 in NHB) NHB and Hispanics tended to be younger than NHW (median ages 57; 54; and 64 years, respectively). Lifetime incidence rates were higher for NHW compared to NHB and Hispanics, but for women younger than 44 years incidence was highest among NHB. NHB also had higher incidence rates of Stage III and IV disease, and higher incidence of TNBC in all age categories. Conclusions Population-based data demonstrate that African American women have a more advanced stage distribution for breast cancer compared to White Americans, and higher incidence rates for TNBC. These patterns are observed for women age 40–49 years as well as older women, and suggest that mammographic screening for early detection of breast cancer will be particularly relevant for younger African American women.
We report on the identification of autoantigens commonly recognized by sera from patients with breast cancer. We selected ten sera from patients with invasive ductal carcinoma (IDC) of the breast with high titer IgG autoantibodies for biopanning of a T7 phage breast cancer cDNA display library. A high throughput method involved the assembly of 938 T7 phages encoding potential breast cancer autoantigens. Microarrays of positive phages were probed with sera from 90 patients with breast cancer [15 patients with ductal carcinoma in situ (DCIS) and 75 patients with IDC of the breast], with 51 non-cancer control sera and with sera from 21 patients with systemic autoimmune diseases. A 12-phage breast cancer predictor group was constructed with phage inserts recognized by sera from patients with breast cancer and not by non-cancer or autoimmune control sera (P < 0.0001). Several autoantigens including annexin XI-A, the p80 subunit of the Ku antigen, ribosomal protein S6, and other unknown autoantigens could significantly discriminate between breast cancer and non-cancer control sera. Biopanning with three different sera led to the cloning of partial cDNA sequences identical to annexin XI-A. IgG autoantibodies reacting with the amino acid 41-74 sequence of annexin XI-A were found in 19% of all women with breast cancer but in 60% of sera from women with DCIS of the breast. In addition, partial sequences identical to annexin XI-A, nucleolar protein interacting with the forkhead-associated (FHA) domain of pKi-67, the KIAA1671 gene product, ribosomal protein S6, cyclin K, elongation factor-2, Grb2-associated protein 2, and other unknown proteins could distinguish DCIS from IDC of the breast and appear to be potential biomarkers for the diagnosis of breast cancer.
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