Tumor characteristics in African American and white women

Springer Science and Business Media LLC - Tập 68 - Trang 33-43 - 2001
Helena Furberg1, Robert Millikan1, Lynn Dressler2, Beth Newman3, Joseph Geradts2
1Department of Epidemiology, School of Public Health; Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, USA
2University of Oxford, Nufflield Department of Pathology and Bacteriology Level 4, Academic Block, John Radcliffe Hospital, Oxford, UK
3School of Public Health, Queensland University of Technology, Brisbane, Australia

Tóm tắt

Background. Previous studies provide evidence that breast cancers occurring in different age and ethnic groups are not evenly distributed with regard to their biologic, pathologic and clinical characteristics. We evaluated the distributions of 11 pathological and biological variables between African-American (AA) and white patients and between three different age groups (20–39, 40–59 and 60–74 years). We examined whether racial differences existed across levels of age. Methods. Data were obtained from the Carolina Breast Cancer Study (CBCS), a population-based, case-control study of breast cancer in North Carolina. Eighty hundred and sixty one women with a first diagnosis of invasive breast cancer participated in Phase I of the CBCS. Diagnostic paraffin blocks were obtained from 807 cases. One representative block was scored for histologic type and grade (architectural, nuclear, mitotic and overall). Medical chart review yielded tumor size, lymph node status, distant metastases, stage, hormone receptor status (ER/PR) and DNA ploidy. Results. Pathologically advanced tumors (large size, high grade, high stage, ER/PR negative) were significantly more common in young and AA women. Racial differences varied by age. Among younger, AAs whites differed only with respect to ER/PR status, while among older women AAs and whites differed only with respect to stage at diagnosis. Conclusions. The results of this study confirm the presence of poorer prognosis breast cancer among AA and younger women. They also highlight the need for age and race to be considered together when evaluating pathologic and biologic characteristics of disease and when making inferences regarding tumor aggressiveness.

Tài liệu tham khảo

Chung M, Chang H, Bland KI, Wanebo HJ: Younger women with breast carcinoma have a poorer prognosis than older women. Cancer 77: 97-103, 1996 Stanford JL, Greenberg R: Breast cancer incidence in young women by estrogen receptor status and race. Am J Public Health 79: 71-73, 1989 Vanlemmens L, Hebbar M, Peyrat JP, Bonneterre J: Age as a prognostic factor in breast cancer. Anticancer Res 18: 1891-1896, 1998 De la Rochefordiere A, Asselain B, Campana F, Scholl S, Fenton J, Vilcoq JR: Age as a prognostic factor in premenopausal breast carcinoma. Lancet 341: 1039-1043, 1993 Bonnier P, Romain S, Charpin C, Lejeune C, Tubiana N, Martin P-M: Age as a prognostic factor in breast cancer: relationship to pathologic and biologic features. Int J Cancer 62: 138-144, 1995 Pillers EMK. Histological grade of breast cancer in younger women. Lancet 339: 1483, 1992 Walker RA, Lees E, Webb MB, Dearing SJ: Breast carcinomas occurring in young women (<35 years) are different. Lancet 74: 1796-1800, 1996 Hulka BS, Chambless LE, Wilkinson WE, Deubner DC, Mc-Carty KS Jr: Hormonal and personal effects on estrogen receptors in breast cancer. Am J Epidemiol 119: 692-704, 1984 Beverly LN, Flanders WD, Go RC, Soong S-J: A comparison of estrogen and progesterone receptors in black and white breast cancer patients. Am J Public Health 77 (3): 351-353, 1987 Stanford JL, Szlko M, Boring CC, Brinton LA, Diamond EA, Greenberg RS: A case-control study of breast cancer stratified by estrogen receptor status. Am J Epidemiol 125: 184-194, 1987 Kovi J, Mohla S, Norris HJ, Sampson CC, Heshmat MY. Breast lesions in Black women. Pathol Ann 199-218, 1989 Chen F, Trapido EJ, Davis K: Differences in stage at presentation of breast cancer and gynecologic cancers among whites, blacks and Hispanics. Cancer 73: 2838-2842, 1994 Weiss SE, Tartter PI, Ahmed S, Brower ST, Crusco C, Bossolt K: Ethnic differences in risk and prognostic factors for breast cancer. Cancer 76: 268-274, 1995 Gapstur SM, Dupuis J, Gann P, Collila S, Winchester DP: Hormone receptor status of breast tumors in Black, Hispanic and Non-Hispanic white women. An analysis of 13,239 cases. Cancer 77: 1465-1471, 1996 Moormeier J: Breast cancer in black women. Ann Intern Med 124: 897-905, 1996 Lyman GH, Kudere NN, Lyman SI, Cox CE, Reintgen D, Baekey P: The importance of race on breast cancer survival. Ann Surg Oncol 4: 80-87, 1997 El-Tamer MB, Wait RB: Age at presentation of African-American and Caucasian breast cancer patients. J Am Coll Surg 188: 237-40, 1999 El-Tamer MB, Homel P, Wait RB: Is race a poor prognostic factor in breast cancer? J Am Coll Surg 189: 41-45, 1999 Mohla S, Sampson C, Khan T, Enterline J, Leffall L Jr, White J: Estrogen and progesterone receptors in breast cancer in Black Americans: correlation of receptor data with tumor differentiation. Cancer 50: 552-559, 1982 Ownby HE, Frederick J, Russo J, Brooks SC, Swanson GM, Heppner GH: Racial differences in breast cancer patients. J Natl Cancer Inst 75: 55-60, 1985 Chen VW, Correa P, Kurman RJ, Wu X-C, Eley WJ, Austin D: Histological characteristics of breast carcinoma in blacks and whites. Cancer Epidemiol Biomark Prevent 3: 127-135, 1994 Elledge RM, Clark GM, Chamness GC, Osborne CK: Tumor biologic factors and breast cancer prognosis among white, Hispanic and Black women in the United States. J Natl Cancer Inst 86: 705-712, 1994 American Cancer Society: Breast cancer facts and figures 1999 Natarajan N, Nemoto T, Mettlin C, Murphy GP: Race related differences in breast cancer patients. Results of the 1982 national survey of breast cancer by the American college of surgeons. Cancer 56: 1704-1709, 1985 Freeman HP, Wasfie TJ: Cancer of the breast in poor black women. Cancer 63: 2562-2569, 1989 Newman B, Moorman PG, Millikan R, Qaqish BF, Geradts J, Aldrich TE: The Carolina breast cancer study: Integrating population-based epidemiology and molecular biology. Breast Cancer Res Treat 35: 51-60, 1995 Aldrich TE, Vann D, Moorman PG, Newman B; Rapid reporting of cancer incidence in a population-based study of breast cancer: one constructive use of a central cancer registry. Breast Cancer Res Treat 35: 61-65, 1995 Weinberg CR, Sandler DP: Randomized recruitment in casecontrol studies. Am J Epidemiol 143: 421-432, 1991 Elston CW and Ellis IO: Pathological prognostic factors in breast cancer. I. The value of histological grade in breast cancer: experience from a large study with long term follow-up. Histopathology 19: 403-410, 1991 Huang, W-Y, Newman B, Millikan R, Schell M, Hulka B: Hormone-related factors and risk of breast cancer in relation to estrogen receptor and progesterone receptor status. Am J Epi 151: 703-714, 2000 SAS Institute: SAS Procedures Guide. Release 7.0. Cary, NC: SAS Institute, 1988 Dawson DA, Thompson GB: Breast cancer risk factors and screening, United States, 1987. Vital and health statistics, Series 10: data from the National Health Survey, no 172. Department of Health and Human Services Publication No. (PHS) 90-1500. Hyattsville, MD: National Center for Health Statistics, 1990 Caplan LS, Wells BS, Haynes S: Breast cancer screening among older racial/ethnic minorities and whites: barriers to early detection. J Gerontol 47: 101-110, 1992 Bartow SA, Parthak DR, Mettler FA: Breast mammographic patterns: a concatenation of confounding and breast cancer. AM J Epidem 142: 813-819, 1995 O'Malley MS, Earp JL, Harris RP: Race and mammography use in two North Carolina counties. Am J Public Health 87: 782-786, 1997 Jones BA, Kasl SV, Curnen MGM, Owens PH, Dubrow R: Can mammography screening explain the race difference in stage at diagnosis of breast cancer. Cancer 75: 2103-2113, 1995 Hunter CP, Redmond C, Chen VW, Austin D, Greenberg RS, Correa P: Breast cancer risk factors associated with stage at diagnosis in black and white women. J Natl Cancer Inst 85: 1129-1137, 1993 Elmore JG, Moceri VM, Carter D, Larson EB: Breast carcinoma tumor characteristics in black and white women. Cancer 83: 2509-2515, 1998 Moorman PG, Jones BA, Millikan RC, Hall IJ, Newman B: Race, anthropometric factors, and stage at diagnosis of breast cancer. AM J Epidem 153: 284-291, 2001