Breast cancer among young African-American women

Abstract

BACKGROUND.African-American women younger than age 45 years have a higher risk of incidence and mortality due to breast cancer than other women. The reason for this disparity in risk is not well understood. METHODS.This review summarizes the literature on the topic of breast cancer in young women and presents a summary of a discussion on this topic during a national forum on breast cancer among African-American women. RESULTS.The occurrence of breast cancer among African-American women younger than the age of 45 years has not been well studied. There is a clear and long-term pattern of higher incidence and mortality and poorer survival in this population subgroup. CONCLUSION.Research is needed to understand the reasons for these disparities and to reduce or eliminate them. Studies focused on hormonal factors, genetic factors, diet and obesity, and timely access to state-of-the-art prevention, information, screening, diagnosis, and treatment are likely to produce important new knowledge in this area. Cancer 2003;97(1 Suppl):273-9.

Epidemiology of basal-like breast cancer

“…Thus, the positive association between parity and basal-like breast cancer was not restricted to the welldocumented short-term increase in risk of breast cancer following live birth [41,43]. Nor did the increase in risk appear to be attributable to younger age at menarche or younger AFFTP which have also been associated with increased risk of breast cancer in younger African-American women [35]. Rather, the increased risk for basal-like breast cancer with increasing parity appeared to be largely confined to women who did not breastfeed (Table 3).…”

“…Therefore, incidence rates and genetic data together support the idea that poor prognosis breast tumors in younger women have a different underlying etiology than more favorable breast cancers in older women. This hypothesis is especially relevant for younger African-American women, for whom breast cancer incidence remains high compared to white women [34] and mortality from hormone receptor negative, high grade breast cancer is a major public health problem [35][36][37].…”

“…Increased parity and younger AFFTP have been associated with increased risk of breast cancer among younger African-American women in several studies [38][39][40] including the CBCS [41], but not in others [42] (for review, see Swanson et al [35]). We observed a statistically significant increase in risk of basal-like breast cancer with increasing number of children, a relationship that was not observed for luminal A breast cancer.…”

Social Determinants of Black-White Disparities in Breast Cancer Mortality: A Review

“…Although higher parity and early age at first full-term pregnancy can decrease breast cancer risk over a woman's life span, some data suggest that these factors may increase risk for breast cancer among younger women (125,126). In addition to reproductive factors, increased risk for breast cancer among young African American women has been associated with behaviors such as low levels of breast feeding, physical inactivity, poor dietary practices, and use of oral contraceptives (28,78). Social and cultural norms play a large role in contraception use, childbearing decisions, infant feeding practices, and lifestyle (127)(128)(129).…”

“…Although over their lifetime, African American women are diagnosed with breast cancer at lower rates than White women, African American women younger than 45 years are diagnosed more frequently than White women (9,12,28). Along with this earlier onset of disease, African American women also tend to be diagnosed with more advancedstage breast cancers than White women (11, 12).…”