African‐American/White differences in breast carcinoma

Abstract

BACKGROUND Despite mounting evidence that breast tumors in African‐American (AA) women are more aggressive compared with breast tumors in white (W) women, little is known regarding racial/ethnic differences in genetic alterations that may be of prognostic importance. METHODS In this population‐based cohort of 322 AA women (45%) and W women (55%) who were diagnosed with breast carcinoma between 1987–1989, the authors evaluated available archived tumor tissue (n = 247 samples) for racial differences in selected genetic alterations and other prognostic indicators. Tumor characteristics were assessed by immunohistochemistry and/or expert review. RESULTS Alterations in p53 were significantly more common in AA women compared with W women (odds ratio, 4.00; 95% confidence interval, 1.77–9.01) and remained statistically significant in models that were adjusted for disease stage at diagnosis, according to American Joint Committee on Cancer (AJCC) criteria, and for other prognostic indicators. No racial difference with regard to HER‐2/neu status was observed, but alterations in c‐met were more common in AA women once the model was adjusted for negative confounders (not significant). Among other tumor characteristics, significant findings included later AJCC stage and higher histologic and nuclear grade tumors in AA women. In addition, the burden of aggressive tumor characteristics was greater in AA women because they were more likely to be at high risk on multiple factors (e.g., both high histologic grade and high nuclear grade [P = 0.03] and negative status for both estrogen receptors and progesterone receptors [P = 0.01]). CONCLUSIONS Data from this population‐based cohort confirmed that breast tumors in AA women most likely are more aggressive compared with breast tumors in W women and offer new evidence for possible racial/ethnic differences with regard to p53 alterations. Cancer 2004. © 2004 American Cancer Society.

Effects of obesity and race on prognosis in lymph node-negative, estrogen receptor-negative breast cancer

“…Recent studies exploring newer molecular markers report that breast tumors from blacks more frequently exhibit aggressive cellular characteristics than tumors from whites of comparable age and stage [45][46][47][48]. For example, tumor cells in black women were 3-5 times more likely to have high mitotic indices, higher levels of p53 and cyclin E, and lower levels of cyclin D, all associated with more aggressive phenotype [46].…”

Impact of Treatment and Socioeconomic Status on Racial Disparities in Survival Among Older Women With Breast Cancer

“…[53][54][55][56] For example, African-American women were more likely to have breast cancer with estrogen receptor negative, poorer grade, higher tumor stage, and other biologic makers (such as p53 and HER-2). [53][54][55][56] Although our study did not have information on p53 and HER-2, the findings on other biologic factors between racial groups were consistent with previous studies. These biologic factors were clearly associated with prognosis and survival.…”

Differential expression and signaling activation of insulin receptor isoforms A and B: A link between breast cancer and diabetes

“…This is significant since AA breast cancer patients have higher levels of p53 inactivation and mutations (Jones et.al, 2004, Olopade et.al., 2003) and mutated p53 “gain of function” results in stimulation of IGF-II (Zhang et.al., 1998) thus, a similar mechanism may increase INSR-A expression among AA.…”