Ethnic differences in risk and prognostic factors for breast cancer

Weiss, Emmanuel; Tartter, Paul Ian; Ahmed, Bina; Brower, Steven T.; Brusco, B A Cristina; Bossolt, B A Kathy; Amberson, J. Burns; Bratton, B A Joan

doi:10.1002/1097-0142(19950715)76:2<268::aid-cncr2820760217>3.0.co;2-1

Cited by 64 publications

(39 citation statements)

References 31 publications

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“…The reasons for this increased mortality are likely to be multifaceted including factors related to socioeconomic status, access to health care, course of treatment, or characteristics of the tumor such as tumor size, grade, or stage [41,[43][44][45][46]. Given that circulating estrogen levels are associated both with breast cancer onset [47,48] and prognosis [2], the results of the present study are consistent with a potential role of IRS-1 in racial/ethnic differences in breast cancer prognosis.…”

Section: Discussionsupporting

confidence: 80%

“…In general, African-American women have higher breast cancer mortality rates than whites [41,42]. The reasons for this increased mortality are likely to be multifaceted including factors related to socioeconomic status, access to health care, course of treatment, or characteristics of the tumor such as tumor size, grade, or stage [41,[43][44][45][46].…”

Section: Discussionmentioning

confidence: 99%

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An association between a common variant (G972R) in the IRS-1 gene and sex hormone levels in post-menopausal breast cancer survivors

Fan

McKean‐Cowdin

Bernstein

et al. 2006

Breast Cancer Res Treat

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Insulin receptor substrate-1 (IRS-1) is a key downstream signaling molecule common to both the insulin and IGF signaling pathways that can interact with the estrogen pathway to regulate breast cell growth. We investigated whether a putative functional variant for IRS-1 (G972R) influences circulating levels of sex hormones, sex hormone binding globulin (SHBG), C-peptide, and insulinlike growth factor 1 (IGF-1) levels among postmenopausal African-American and non-Hispanic white breast cancer patients enrolled in the Health, Eating, Activity, and Lifestyle (HEAL) Study. Circulating levels of sex hormones and growth factors can influence breast cancer recurrence and survival. Serum estrone, estradiol, testosterone, SHBG, IGF-1 and C-peptide were measured in 468 patients at 30+ months post diagnosis. Non-protein bound hormone levels (free estradiol, free testosterone) were calculated. In African-American patients, the IRS-1 variant was associated with increased serum levels of estrone (p=0.02), free estradiol (p=0.04), total testosterone (p=0.04), free testosterone (p=0.006) and decreased levels of sex hormone-binding globulin (p=0.02). No association was present for white patients. Our findings provide suggestive evidence that IRS-1 G972R variant may be associated with circulating levels of sex hormones and SHBG in African American breast cancer survivors.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

An association between a common variant (G972R) in the IRS-1 gene and sex hormone levels in post-menopausal breast cancer survivors

Fan

McKean‐Cowdin

Bernstein

et al. 2006

Breast Cancer Res Treat

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“…This finding is consistent with those of some previous studies. 17,[25][26][27][28] However, it is inconsistent with findings in other previous studies, which show that obesity is associated with both tumor size and node status. 16,23,24 There may be several reasons for the observed association between body mass and stage of breast cancer at diagnosis.…”

Section: Discussionmentioning

confidence: 72%

“…In addition, some studies report that both large tumor size and lymph node involvement are associated with higher body weight, 16,23,24 whereas other studies report that tumor size, but not lymph node involvement are associated with higher body weight. 17,[25][26][27][28] Furthermore, 1 study has reported that lymph node involvement, but not tumor size, is associated with obesity. 29 In obese women with larger breasts, palpation for lumps may be more difficult, resulting in delay in detection and diagnosis of breast cancer.…”

mentioning

confidence: 99%

Body mass and stage of breast cancer at diagnosis

Cui

Whiteman

Flaws

et al. 2001

Intl Journal of Cancer

155

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Obesity is a well-known risk factor for postmenopausal breast cancer. In contrast, the relationship between obesity and stage of breast cancer at diagnosis is less clear. We hypothesized that increased breast size in obese women may delay discovery of breast tumors. Thus, the purpose of our study was to examine whether there is an association between body mass and stage of breast cancer at diagnosis using hospital medical records. Newly diagnosed breast cancer cases (n ‫؍‬ 966) in the Baltimore metropolitan area from 1991 to 1997 were included in our study. Obesity is a well-known risk factor for breast cancer, with the effect being limited to postmenopausal women. [1][2][3][4][5][6][7][8][9] In premenopausal women, there is an inverse association between body mass and the risk of breast cancer, i.e., obese women are less likely to get breast cancer than nonobese women. In contrast, the relationship between obesity and stage at diagnosis in either premenopausal or postmenopausal women is less clear. This is partially because this relationship has not been studied in detail and the results from existing studies are equivocal. For example, several 10 -20 but not all 21,22 studies report that being overweight is associated with late stage at diagnosis. In addition, some studies report that both large tumor size and lymph node involvement are associated with higher body weight, 16,23,24 whereas other studies report that tumor size, but not lymph node involvement are associated with higher body weight. 17,[25][26][27][28] Furthermore, 1 study has reported that lymph node involvement, but not tumor size, is associated with obesity. 29 In obese women with larger breasts, palpation for lumps may be more difficult, resulting in delay in detection and diagnosis of breast cancer. This idea is supported by studies showing that women with large breasts (or bra size as a surrogate) are more likely to be diagnosed at a later stage of breast cancer than women with small breasts. 18,28,30 A study by Reeves et al. 11 reported that the positive association between body mass index (BMI) and stage was confined to tumors that were detected by women themselves. In a recent study, however, Hall et al. 18 reported that the observed positive association was not modified by method of detection.The purpose of our study was to help clarify the relationship between body mass and breast cancer by determining whether there is an association between obesity and stage of breast cancer at diagnosis. We also wished to determine whether there is a positive association between obesity and each of the 3 components for tumor staging (tumor size, node status and distant metastasis) and to explore whether the association between obesity and tumor stage was modified by age. MATERIAL AND METHODS Study subjectsThis is a case series study of breast cancer using data from hospital medical records. Breast cancer cases were obtained from 2 hospitals in the Baltimore metropolitan area. Although all recorded cases of breast cancer were obtained by the investig...

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“…However, several molecular indices of breast carcinoma biology and their prevalence have been reported to be similar between African-American and Caucasian women. 19,20 In view of these important observations, we evaluated the prevalence of positive HER-2/neu breast carcinoma in a cohort of AfricanAmerican and Caucasian women diagnosed with invasive breast carcinoma. In addition, we evaluated race-specific risk for positive HER-2/neu breast carcinoma given the pathologic prognostic indicators used in clinical settings.…”

mentioning

confidence: 99%

Race modifies the association between breast carcinoma pathologic prognostic indicators and the positive status for HER‐2/neu

Stark

Claud

Kapke

et al. 2005

Cancer

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BACKGROUNDInferences about the variations in the biology of breast carcinoma between African‐Americans and Caucasians have been reported. The difference in the prevalence of positive HER‐2/neu breast carcinoma was evaluated and the race‐specific risk was assessed for positive HER‐2/neu among a cohort of women diagnosed with their first primary breast carcinoma, given the accepted prognostic pathologic indicators for positive HER‐2/neu status.METHODSDemographic, clinical, and pathologic data were collected from existing databases. The status of HER‐2/neu was considered positive if the immunohistochemistry score was 3+ or if the fluorescent in situ hybridization indicated a ratio greater than 2. Multivariable logistic regression was used to determine the race‐specific risk for HER‐2/neu positive breast carcinoma.RESULTSThe difference in the prevalence of HER‐2/neu‐positive status between African‐American and Caucasian women was not statistically significant (P = 0.46). For Caucasian women the likelihood for positive HER‐2/neu was statistically significant and increased almost linearly within each stage with nuclear grade dedifferentiation relative to the reference group, women with Stage 1, Grade 1 carcinomas. For African‐American women, this risk was not significantly associated with stage, nuclear grade, their interaction term, or other pathologic prognostic indicators.CONCLUSIONSThe findings suggest that race modifies the association between the pathologic prognostic indicators of breast carcinoma and the likelihood of HER‐2/neu‐positive carcinoma. So far, clinical correlative studies of HER‐2/neu have not included race as an independent variable. Concerns about the limited generalizability and the need for validation of the findings across racial lines have been expressed previously. Cancer 2005. © 2005 American Cancer Society.

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Ethnic differences in risk and prognostic factors for breast cancer

Cited by 64 publications

References 31 publications

An association between a common variant (G972R) in the IRS-1 gene and sex hormone levels in post-menopausal breast cancer survivors

An association between a common variant (G972R) in the IRS-1 gene and sex hormone levels in post-menopausal breast cancer survivors

Body mass and stage of breast cancer at diagnosis

Race modifies the association between breast carcinoma pathologic prognostic indicators and the positive status for HER‐2/neu

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