Chinese language - Breast cancer more deadly in black women

?  ?

WORLD / Health

Breast cancer more deadly in black women

(AP)
Updated: 2007-09-07 11:33

A new study gives a possible explanation for why breast cancer is more
deadly in black women: they are more likely to have tumors that do not
respond to the hormone-based treatments that help many others with the
disease.

The study is the largest yet to link a biological factor to the racial
disparity, which also has been blamed on black women getting fewer
mammograms and less aggressive treatment.

"This puts biology more to the forefront," said Dr Julie Gralow, a cancer
specialist at the University of Washington School of Medicine familiar
with the work. "It's not just access to care, access to treatment and
other factors that have been implicated in the past."

The study was led by Dr M. Catherine Lee of the University of Michigan
Comprehensive Cancer Center and is to be presented at a conference
starting Friday in San Francisco, organized by the American Society of
Clinical Oncology and other cancer groups.

Breast cancer is the most common cancer in American women. An estimated
178,480 new cases and 40,460 deaths from it are expected in the United
States this year.

Blacks are less likely than whites to develop breast cancer but are more
likely to die from it, doctors have long known. Blacks also are diagnosed
at younger ages and at later stages of disease.

Researchers for the first time used the National Cancer Data Base, a
tumor registry maintained by the American College of Surgeons, to explore
these issues, using more than 170,000 cases diagnosed in 1998. Ten
percent were in black women.

The study focused on the 95,500 women whose cancers were invasive rather
than still confined to a milk duct. About 39 percent of such tumors in
black women were estrogen receptor-negative, or ER-negative, compared
with 22 percent of those in white women.

Estrogen helps tumors grow. Drugs that block this hormone, like tamoxifen
and a newer class of medications called aromatase inhibitors, work
against these cancers.

ER-negative tumors are resistant to such therapies and harder to treat.
Other tools like chemotherapy, radiation and targeted biological drugs
then become more important for such women, and doctors should consider
this when they evaluate black women with the disease, Lee said.

In the study, ER-negative tumors were more common in black women at every
stage of disease and at all ages.

For example, only 17 percent of early stage tumors in white women were
ER-negative, but 31 percent in black women were. Of the most advanced
cancers, 31 percent in whites and 46 percent in blacks were ER-negative.

Echoing previous research, the new study found that black women were
diagnosed at younger ages - an average of 57 years old versus 62 for
white women - and with more advanced disease: only 29 percent had early
stage tumors versus 42 percent of white women. They also had larger
tumors and more cell traits that are signs of a poor prognosis.

Smaller studies have suggested biological differences between breast
cancer in blacks and whites. Earlier this year, the Carolina Breast
Cancer Study found that young black women were more likely to have an
aggressive form called the basal-like subtype.

Last fall, two studies by researchers from the University of Texas M.D.
Anderson Cancer Center found that black women were more likely to have
larger, later-stage tumors and lower survival rates than Hispanic and
white women given similar treatments.

But these findings do not mean that differences in screening and health
care are not contributing to the trend, especially in certain parts of
the country, said Dr Wendy Woodward, a breast cancer specialist at M.D.
Anderson.

"You really have to kind of go at the problem from all angles. If you
solve the access problem and women come in and you don't have an adequate
therapy for them, you haven't taken a step forward," she said.

Dr Len Lichtenfeld, deputy chief medical officer of the American Cancer
Society, agreed. Racial disparity in breast cancer survival did not
appear until the mid-1980s, suggesting that much of it is due to lack of
screening mammograms and access to care, he said.

Top World News ?

* Crowd mourns Pavarotti in his hometown
* Groups: Bin Laden plans video on 9/11
* Study: US should lower profile in Iraq
* Italian tenor Pavarotti is dead
* Social security scandal angers Japanese

Today's Top News ?

* Hu tells Bush: It's time to 'get tough on Taiwan'
* Wen outlines economic strategies
* Bin Laden plans video on 9/11 - group
* Chinese men win gymnastics title
* APEC outlines trade, security policies

Most Commented/Read Stories in 48 Hours

Learn Chinese, Chinese Mandarin, Learning Materials, Mandarin audio lessons, Chinese writing lessons, Chinese vocabulary lists, About chinese characters, News in Chinese, Go to China, Travel to China, Study in China, Teach in China, Dictionaries, Learn Chinese Painting, Your name in Chinese, Chinese calligraphy, Chinese songs, Chinese proverbs, Chinese poetry, Chinese tattoo, Beijing 2008 Olympics, Mandarin Phrasebook, Chinese editor, Pinyin editor, China Travel, Travel to Beijing, Travel to Tibet