Breast Cancer and African Ancestry: Lessons Learned at the 10-Year Anniversary of the Ghana-Michigan Research Partnership and International Breast Registry

Abstract

Women with African ancestry in western, sub-Saharan Africa and in the United States represent a population subset facing an increased risk of being diagnosed with biologically aggressive phenotypes of breast cancer that are negative for the estrogen receptor, the progesterone receptor, and the HER2/neu marker. These tumors are commonly referred to as triple-negative breast cancer. Disparities in breast cancer incidence and outcome related to racial or ethnic identity motivated the establishment of the International Breast Registry, on the basis of partnerships between the Komfo Anokye Teaching Hospital in Kumasi, Ghana, the University of Michigan Comprehensive Cancer Center in Ann Arbor, Michigan, and the Henry Ford Health System in Detroit, Michigan. This research collaborative has featured educational training programs as well as scientific investigations related to the comparative biology of breast cancer in Ghanaian African, African American, and white/European American patients. Currently, the International Breast Registry has expanded to include African American patients throughout the United States by partnering with the Sisters Network (a national African American breast cancer survivors’ organization) and additional sites in Ghana (representing West Africa) as well as Ethiopia (representing East Africa). Its activities are now coordinated through the Henry Ford Health System International Center for the Study of Breast Cancer Subtypes. Herein, we review the history and results of this international program at its 10-year anniversary.

African Clinicians’ Prioritization of Needs in International Breast Cancer Partnerships

“…Methods | The International Center for the Study of Breast Cancer Subtypes (ICS BCS) 5 convened its first multidisciplinary breast cancer symposium in partnership with the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, in August 2017; both ICS BCS and KATH promoted attendance through flyers and direct communications. Attendees were asked to complete a single-page survey (jointly drafted by the ICS BCS and KATH staff) to provide information regarding their profession and an assessment of the needs that they believed could be addressed by international partners from more affluent countries.…”

Identification of Distinct Heterogenic Subtypes and Molecular Signatures Associated With African Ancestry in Triple Negative Breast Cancer Using Quantified Genetic Ancestry Models in Admixed Race Populations

“…The onset of race-group mortality rate disparities coincides with the advent of hormone-targeted therapies [5] that are now standard-of-care for hormone receptor-positive tumors. Compared to women of European descent, AA women [4,[6][7][8][9][10][11][12][13] and women of African descent world-wide [9,[14][15][16] have a higher incidence of triple-negative breast cancer (TNBC) [17][18][19][20][21], which is characterized by the absence of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2). Therefore, in the context of standardizing ER/PR-and HER2-targeted therapies, the divergence of AA vs EA mortality likely unmasked population-level differences in tumor biology, which we have previously shown to correlate with genetic ancestry [22].…”

Development of multi-disciplinary breast cancer care in Southern Malawi

“…This gives an incidence rate around 1 per 100 000 per year, at the lower end of the range expected in this region. The incidence of breast cancer appears to be rising in low-and middle-income countries (LMICs) and lack of early detection programmes as well as sociocultural barriers lead to breast cancer often presenting in late stages (Jiagge, Oppong, & Bensenhaver, 2016;Kantelhardt, Cubasch, & Hanson, 2015;Newman, 2015;Sutter, Slinker, Balumuka, & Mitchell, 2016). The incidence of breast cancer appears to be rising in low-and middle-income countries (LMICs) and lack of early detection programmes as well as sociocultural barriers lead to breast cancer often presenting in late stages (Jiagge, Oppong, & Bensenhaver, 2016;Kantelhardt, Cubasch, & Hanson, 2015;Newman, 2015;Sutter, Slinker, Balumuka, & Mitchell, 2016).…”

“…Globocan (Ferlay et al, 2013) estimates of 762 incident case (with 397 deaths) annually suggests substantial under registration either from breast cancer cases not reaching medical care and/or not being reported to the cancer registry. The incidence of breast cancer appears to be rising in low-and middle-income countries (LMICs) and lack of early detection programmes as well as sociocultural barriers lead to breast cancer often presenting in late stages (Jiagge, Oppong, & Bensenhaver, 2016;Kantelhardt, Cubasch, & Hanson, 2015;Newman, 2015;Sutter, Slinker, Balumuka, & Mitchell, 2016).…”