© 2005 Oxford University Press
ARTICLE |
Ethnicity and Breast Cancer: Factors Influencing Differences in Incidence and Outcome
Affiliations of authors: Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance (RTC); Mel & Enid Zuckerman Arizona College of Public Health, University of Arizona, Tucson (ZC); Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA (AM, GLA, AA, RP); Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (TR); Department of Preventive Medicine, State University of New York at Stony Brook, Stony Brook (DL); Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL (NCD); School of Public Health, The Ohio State University, Columbus (EDP); Department of Medicine, University of California at Irvine, Irvine (FAH); Department of Medicine, Howard University Cancer Center, Washington, DC (LLA-C)
Correspondence to: Rowan T. Chlebowski, MD, PhD, at Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 W. Carson St., Building J-3, Torrance, CA 90502 (e-mail rchlebow{at}whi.org).
Background: The lower breast cancer incidence in minority women and the higher breast cancer mortality in African American women than in white women are largely unexplained. The influence of breast cancer risk factors on these differences has received little attention. Methods: Racial/ethnic differences in breast cancer incidence and outcome were examined in 156 570 postmenopausal women participating in the Women's Health Initiative. Detailed information on breast cancer risk factors including mammography was collected, and participants were followed prospectively for breast cancer incidence, pathological breast cancer characteristics, and breast cancer mortality. Comparisons of breast cancer incidence and mortality across racial/ethnic groups were estimated as hazard ratios (HRs) and 95% confidence intervals (CIs) from Cox proportional hazard models. Tumor characteristics were compared as odds ratios (ORs) and 95% confidence intervals in logistic regression models. Results: After median follow-up of 6.3 years, 3938 breast cancers were diagnosed. Age-adjusted incidences for all minority groups (i.e., African American, Hispanic, American Indian/Alaskan Native, and Asian/Pacific Islander) were lower than for white women, but adjustment for breast cancer risk factors accounted for the differences for all but African Americans (HR = 0.75, 95% CI = 0.61 to 0.92) corresponding to 29 cases and 44 cases per 10 000 person years for African American and white women, respectively. Breast cancers in African American women had unfavorable characteristics; 32% of those in African Americans but only 10% in whites were both high grade and estrogen receptor negative (adjusted OR = 4.70, 95% CI = 3.12 to 7.09). Moreover, after adjustment for prognostic factors, African American women had higher mortality after breast cancer than white women (HR = 1.79, 95% CI = 1.05 to 3.05) corresponding to nine and six deaths per 10 000 person-years from diagnosis in African American and white women, respectively. Conclusion: Differences in breast cancer incidence rates between most racial/ethnic groups were largely explained by risk factor distribution except in African Americans. However, breast cancers in African American women more commonly had characteristics of poor prognosis, which may contribute to their increased mortality after diagnosis.
CiteULike 
Connotea 
Del.icio.us What's this?
Find additional patient-related information at:
Correspondence about this Article
- Re: Ethnicity and Breast Cancer: Factors Influencing Differences in Incidence and Outcome
- Lisa Richardson
J Natl Cancer Inst 2005 97: 1619.[Extract] [Full Text] [PDF]
This article has been cited by other articles:
|
|
 |
|
  F. McKenzie and M. Jeffreys Do Lifestyle or Social Factors Explain Ethnic/Racial Inequalities in Breast Cancer Survival? Epidemiol. Rev., November 1, 2009; 31(1): 52 - 66. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Fejerman, C. A. Haiman, D. Reich, A. Tandon, R. C. Deo, E. M. John, S. A. Ingles, C. B. Ambrosone, D. H. Bovbjerg, L. H. Jandorf, et al. An Admixture Scan in 1,484 African American Women with Breast Cancer Cancer Epidemiol. Biomarkers Prev., November 1, 2009; 18(11): 3110 - 3117. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Huo, F. Ikpatt, A. Khramtsov, J.-M. Dangou, R. Nanda, J. Dignam, B. Zhang, T. Grushko, C. Zhang, O. Oluwasola, et al. Population Differences in Breast Cancer: Survey in Indigenous African Women Reveals Over-Representation of Triple-Negative Breast Cancer J. Clin. Oncol., September 20, 2009; 27(27): 4515 - 4521. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Min, Z. Yu, K. H. Kirsch, Y. Zhao, S. R. Vora, P. C. Trackman, D. B. Spicer, L. Rosenberg, J. R. Palmer, and G. E. Sonenshein A Loss-of-Function Polymorphism in the Propeptide Domain of the LOX Gene and Breast Cancer Cancer Res., August 15, 2009; 69(16): 6685 - 6693. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. C Kabat, M. Kim, L. L Adams-Campbell, B. J Caan, R. T Chlebowski, M. L Neuhouser, J. M Shikany, and T. E Rohan Longitudinal study of serum carotenoid, retinol, and tocopherol concentrations in relation to breast cancer risk among postmenopausal women Am. J. Clinical Nutrition, July 1, 2009; 90(1): 162 - 169. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Dawood, K. Broglio, S.-W. Kau, M. C. Green, S. H. Giordano, F. Meric-Bernstam, T. A. Buchholz, C. Albarracin, W. T. Yang, B. T.J. Hennessy, et al. Triple Receptor-Negative Breast Cancer: The Effect of Race on Response to Primary Systemic Treatment and Survival Outcomes J. Clin. Oncol., January 10, 2009; 27(2): 220 - 226. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Harper, J. Lynch, S. C. Meersman, N. Breen, W. W. Davis, and M. C. Reichman Trends in Area-Socioeconomic and Race-Ethnic Disparities in Breast Cancer Incidence, Stage at Diagnosis, Screening, Mortality, and Survival among Women Ages 50 Years and Over (1987-2005) Cancer Epidemiol. Biomarkers Prev., January 1, 2009; 18(1): 121 - 131. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. D. McKay, M. L. McCullough, R. G. Ziegler, P. Kraft, B. S. Saltzman, E. Riboli, A. Barricarte, C. D. Berg, G. Bergland, S. Bingham, et al. Vitamin D Receptor Polymorphisms and Breast Cancer Risk: Results from the National Cancer Institute Breast and Prostate Cancer Cohort Consortium Cancer Epidemiol. Biomarkers Prev., January 1, 2009; 18(1): 297 - 305. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Fejerman, E. M. John, S. Huntsman, K. Beckman, S. Choudhry, E. Perez-Stable, E. G. Burchard, and E. Ziv Genetic Ancestry and Risk of Breast Cancer among U.S. Latinas Cancer Res., December 1, 2008; 68(23): 9723 - 9728. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Dawood, K. Broglio, A. M. Gonzalez-Angulo, A. U. Buzdar, G. N. Hortobagyi, and S. H. Giordano Trends in Survival Over the Past Two Decades Among White and Black Patients With Newly Diagnosed Stage IV Breast Cancer J. Clin. Oncol., October 20, 2008; 26(30): 4891 - 4898. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Gurwitz and W. Newman Re: Pharmacogenomic Variation of CYP2D6 and the Choice of Optimal Adjuvant Endocrine Therapy for Postmenopausal Breast Cancer: A Modeling Analysis J Natl Cancer Inst, September 17, 2008; 100(18): 1331 - 1331. [Full Text] [PDF]
|
|
|
|
 |
|
 D. E. Rollison, A. R. Giuliano, T. A. Sellers, C. Laronga, C. Sweeney, B. Risendal, K. B. Baumgartner, T. Byers, and M. L. Slattery Population-based Case-Control Study of Diabetes and Breast Cancer Risk in Hispanic and Non-Hispanic White Women Living in US Southwestern States Am. J. Epidemiol., February 15, 2008; 167(4): 447 - 456. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. H. Gail, J. P. Costantino, D. Pee, M. Bondy, L. Newman, M. Selvan, G. L. Anderson, K. E. Malone, P. A. Marchbanks, W. McCaskill-Stevens, et al. Projecting Individualized Absolute Invasive Breast Cancer Risk in African American Women J Natl Cancer Inst, December 5, 2007; 99(23): 1782 - 1792. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. M. E. Hahn, M. L. Bondy, M. Selvan, M. J. Lund, J. M. Liff, E. W. Flagg, L. A. Brinton, P. Porter, J. W. Eley, and R. J. Coates Factors Associated with Advanced Disease Stage at Diagnosis in a Population-based Study of Patients with Newly Diagnosed Breast Cancer Am. J. Epidemiol., November 1, 2007; 166(9): 1035 - 1044. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Sweeney, R. K. Wolff, T. Byers, K. B. Baumgartner, A. R. Giuliano, J. S. Herrick, M. A. Murtaugh, W. S. Samowitz, and M. L. Slattery Genetic Admixture among Hispanics and Candidate Gene Polymorphisms: Potential for Confounding in a Breast Cancer Study? Cancer Epidemiol. Biomarkers Prev., January 1, 2007; 16(1): 142 - 150. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B Moy, D Tu, J. Pater, J. Ingle, L. Shepherd, T. Whelan, and P. Goss Clinical outcomes of ethnic minority women in MA.17: a trial of letrozole after 5 years of tamoxifen in postmenopausal women with early stage breast cancer Ann. Onc., November 1, 2006; 17(11): 1637 - 1643. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Amend, D. Hicks, and C. B. Ambrosone Breast Cancer in African-American Women: Differences in Tumor Biology from European-American Women. Cancer Res., September 1, 2006; 66(17): 8327 - 8330. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. F. Anderson and R. Matsuno Breast cancer heterogeneity: a mixture of at least two main types? J Natl Cancer Inst, July 19, 2006; 98(14): 948 - 951. [Full Text] [PDF]
|
|
|
|
 |
|
 C. Smigal, A. Jemal, E. Ward, V. Cokkinides, R. Smith, H. L. Howe, and M. Thun Trends in breast cancer by race and ethnicity: update 2006. CA Cancer J Clin, May 1, 2006; 56(3): 168 - 183. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Rosenberg, J. R. Palmer, L. A. Wise, and L. L. Adams-Campbell A prospective study of female hormone use and breast cancer among black women. Arch Intern Med, April 10, 2006; 166(7): 760 - 765. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. R. Schover, R. Jenkins, D. Sui, J. H. Adams, M. S. Marion, and K. E. Jackson Randomized Trial of Peer Counseling on Reproductive Health in African American Breast Cancer Survivors J. Clin. Oncol., April 1, 2006; 24(10): 1620 - 1626. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. A. Newman, K. A. Griffith, I. Jatoi, M. S. Simon, J. P. Crowe, and G. A. Colditz Meta-Analysis of Survival in African American and White American Patients With Breast Cancer: Ethnicity Compared With Socioeconomic Status J. Clin. Oncol., March 20, 2006; 24(9): 1342 - 1349. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. M. John, A. I. Phipps, A. Davis, and J. Koo Migration History, Acculturation, and Breast Cancer Risk in Hispanic Women Cancer Epidemiol. Biomarkers Prev., December 1, 2005; 14(12): 2905 - 2913. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Richardson Re: Ethnicity and Breast Cancer: Factors Influencing Differences in Incidence and Outcome J Natl Cancer Inst, November 2, 2005; 97(21): 1619 - 1619. [Full Text] [PDF]
|
|
|
|
|
|
R. T. Chlebowski, R. Prentice, and L. L. Adams-Campbell RESPONSE: Re: Ethnicity and Breast Cancer: Factors Influencing Differences in Incidence and Outcome J Natl Cancer Inst, November 2, 2005; 97(21): 1619 - 1620. [Full Text] [PDF]
|
|
|
|
|
|
I. Jatoi, W. F. Anderson, S. R. Rao, and S. S. Devesa Breast Cancer Trends Among Black and White Women in the United States J. Clin. Oncol., November 1, 2005; 23(31): 7836 - 7841. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. L. McCullough, H. S. Feigelson, W. R. Diver, A. V. Patel, M. J. Thun, and E. E. Calle Risk Factors for Fatal Breast Cancer in African-American Women and White Women in a Large US Prospective Cohort Am. J. Epidemiol., October 15, 2005; 162(8): 734 - 742. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. D. Brenton, L. A. Carey, A. A. Ahmed, and C. Caldas Molecular Classification and Molecular Forecasting of Breast Cancer: Ready for Clinical Application? J. Clin. Oncol., October 10, 2005; 23(29): 7350 - 7360. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Breast Cancer in Blacks: Less Common, More Deadly Journal Watch Women's Health, May 3, 2005; 2005(503): 1 - 1. [Full Text]
|
|