The age-adjusted death rate in the United States from breast cancer in white women is 28.3 deaths per 100,000 compared with 36.4 deaths per 100,000 in African American women. This disparity is particularly pronounced among women younger than 50 years, in whom the death rate is 77 percent higher among African American women compared with white women.

Lisa A. Carey, M.D., of the University of North Carolina-Lineberger Comprehensive Cancer Center, Chapel Hill, N.C., and colleagues conducted a study of environmental and molecular determinants of breast cancer risk to identify breast tumour subtypes and determine associations between tumour subtypes and race, menopausal status, tumour characteristics, and survival. The Carolina Breast Cancer Study, a population-based study, included 496 incident cases of invasive breast cancer.

The researchers found that one of the more aggressive subtypes, the basal-like breast cancer subtype, was more prevalent among pre-menopausal African American women (39 percent) compared with post-menopausal African American women (14 percent) and non-African American women (16 percent) of any age, whereas the luminal A subtype was less prevalent (36 percent vs. 59 percent-54 percent, respectively). The HER2+/ER-subtype did not vary with race or menopausal status (6 percent-9 percent). In this cohort of patients diagnosed between 1993-96, breast cancer specific survival differed by subtype, with shortest survival among HER2+/ER- and basal-like subtypes.

“The high prevalence of basal-like tumours in younger African American women could contribute to their higher breast cancer mortality. Additional studies of long-term survival among patients with specific breast cancer subtypes are needed. Clinical trials aimed at identifying therapeutic approaches to the management of basal-like breast cancer are also needed, especially for young African American women,” the authors conclude.; Source: American Medical Association (AMA)