Although the odds of developing breast cancer are nearly identical for black and white women, black women are 42 percent more likely to die from the disease. This mortality gap - driven by social and environmental, as well as biological factors - continues to persist.
A large, multi-institutional study, published on-line May 4, 2017, in JAMA Oncology, was designed to understand this gap by beginning to unravel the germline genetic variations and tumor biological differences between black and white women with breast cancer. This is the first "ancestry-based comprehensive analysis of multiple platforms of genomic and proteomic data of its kind," the authors note.
Findings from this study could lead to more personalized risk assessment for women of African heritage and hasten the development of novel approaches designed to diagnose specific subtypes of aggressive breast cancers early and treat them effectively.
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One new finding is that black women with hormone receptor positive, HER2-negative breast cancer had a higher risk-of-recurrence score than white women. The study also confirmed that black patients were typically diagnosed at a younger age and were more likely to develop aggressive breast-cancer subtypes, including basal-like or triple-negative cancers (tumors lacking estrogen receptors, progesterone receptors and HER2), as well as other aggressive tumor subtypes.
"People have long associated breast cancer mortality in black women with poverty, or stress, or lack of access to care, but our results show that much of the increased risk for black women can be attributed to tumor biological differences, which are probably genetically determined," said study author Olufunmilayo Olopade, MD, professor of medicine and human genetics at the University of Chicago.
"The good news," she said, "is that as we learn more about these genetic variations, we can combine that information with clinical data to stratify risk and better predict recurrences - especially for highly treatable cancers - and develop interventions to improve treatment outcomes."
"This is a great example of how team science and investments in science can accelerate progress in identifying the best therapies for the most aggressive breast cancers," said co-author Charles Perou, PhD, a member of the University of North Carolina Lineberger Comprehensive Cancer Center and professor of genetics, and pathology & laboratory medicine at the UNC School of Medicine.
