A genetic mutation related to a more aggressive form of breast cancer occurs four times more often in African-American patients than their white counterparts, Yale researchers reported in the Aug. 9 online edition of the journal Cancer.
In the United States, African-American women have a lower incidence of breast cancer than white women, but they have a higher mortality rate. The disease also develops at an earlier age and is more aggressive in African-American women. To explore the reasons for the differences, Beth A. Jones, assistant professor in the Department of Epidemiology & Public Health at the School of Medicine, and her colleagues studied the effects of alterations in a tumor suppressor gene called p53.
The team looked at how the patterns of alterations of genes that are related to worse prognosis differed between African-American and white women. They examined the breast tumors of 145 African-American and 177 white women and found that African-American women were four times more likely than white women to show significant alterations in the p53 gene.
"This is the first population-based study to report a clearly significant increase in p53 mutations that is independent of race differences in other tumor characteristics, socioeconomic status and other biomedical and lifestyle factors," says Jones.
The authors also confirmed that tumors in African-American women were more likely to display characteristics associated with poor prognosis than those in whites. Jones says confirmation of these earlier reports is an important contribution since few population-based studies have access to detailed patient information and tumor information assessed in a single laboratory using standardized methodology.
Past explanations for the racial/ethnic differences included socioeconomic factors, nutrition and healthcare behavior, but Jones stresses that while many factors contribute to the relatively poor outcome for some African-American breast cancer patients, understanding the underlying biological mechanisms is critical.
"Our goal is to continue to illuminate the reasons for the differences, so we can ultimately develop prevention strategies and tailor treatments more effectively," says Jones.
Other authors on the study include Stanislav V. Kasl, Christine L. Howe, Mary Lachman, Robert Dubrow, Mary McCrea Curnen, Hosanna Soler-Vila, Alicia Beeghly, Fenghai Duan and Patricia Owens. The work was funded by grants from the Department of Defense Breast Cancer Research Program and the National Cancer Institute.
-- By Karen Peart
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