Breast tumors more aggressive in African Americans

Features of aggressive breast tumors, including alterations in the tumor suppressor gene p53, are more common among African American women than among white women, according to a report in the current online edition of the journal Cancer.

The study findings confirm those that have been reported by others with respect to tumor stage, size, grade, and estrogen receptor status, Dr. Beth A. Jones from Yale University School of Medicine, New Haven, Connecticut told Reuters Health. But they also add specific molecular alterations to the list.

Jones and colleagues studied 145 African American and 177 white women with breast cancer to determine if there are differences in certain genes that have been associated with a poor prognosis in breast cancer patients. The researchers looked at p53, HER-2 and c-met genes.

African American women were more likely than white women to be diagnosed with later stage breast cancer, with more aggressive tumors, and with tumors that lack estrogen receptors, the authors report.

In addition, tumors from African American women were more likely than those from white women to have alterations in p53, the investigators note.

"At this time, it seems that we have a fair number of studies that indicate that tumors that occur in African American women tend to be more aggressive. Additionally, breast cancer occurs at a younger age in African American women," Jones said.

"Physicians should be aware of these two facts and encourage African American women to begin screening at age 40 and to adhere to guidelines - i.e., annual exams (rather than every 1-2 years as recommended by some)."

"The critical message is that the door to the improved understanding of ethnicity-related variation in breast carcinoma risk and outcome has now been wedged open by the powerful tools of molecular biology," writes Dr. Lisa A. Newman from University of Michigan, Ann Arbor, in a related editorial.

"It is our responsibility as clinicians and investigators to accept the challenge of conducting the studies, collecting and interpreting the data, and validating the results."

"Hopefully," Newman concludes, "the return from our success in meeting this challenge will be the ability to lower risk and improve the treatment efficacy for our collective, diverse patient populations."

SOURCE: Cancer, August 9, 2004.