December 28, 2006

Tailored Breast Cancer Care Urged for Black Women
(Reuters Health)

African-American breast cancer patients may be harder hit by the disease than whites due to the type of tumors they tend to develop, rather than socioeconomic factors alone, a new study suggests.

Based on the findings, more efforts must be made to tailor treatments to the more-aggressive tumor types that frequently occur in black women, Dr. Wendy A. Woodward told Reuters Health.

"We're coming into an era where breast cancer therapy is more and more individualized. We really need to be sure that that individualized therapy is benefiting everyone," said Woodward, of the University of Texas M. D. Anderson Cancer Center in Houston.

Worse access to health care, poverty and similar factors are frequently blamed for black women's lower rate of survival after a breast cancer diagnosis, Woodward and her colleagues note in the medical journal Cancer. On the other hand, it is possible that African-American women may have more severe disease than whites due to biological characteristics of their tumors, they add.

To investigate, the researchers looked at 2,140 women participating in two clinical trials of chemotherapy for breast cancer.

In both trials, the researchers found, black women were diagnosed with later-stage cancer, and were also more likely to have tumors that did not carry an estrogen receptor, which is usually a poor sign.

Black women's survival rates were lower than for whites and for Hispanic women. In one trial, 52% of black women survived for 10 years, compared to 62% of whites and Hispanics. In the other, 10-year survival for blacks was 40%, while it was 50% for whites and 56% for Hispanics.

The socioeconomic profile of Hispanic women living in the Houston area is similar to that of African-American women, but Hispanic women consistently fared as well as or better than blacks, Woodward and her team note.

Moreover, they add, given that all the women were in the same clinical trial, they were likely receiving virtually identical treatment. This suggests that something beyond socioeconomic factors may be influencing black women's breast cancer survival.

Woodward pointed out in an interview that the aggressive breast cancer seen in many black women is similar to the virulent disease that often strikes younger women diagnosed with breast cancer.

Known as "triple negative" disease, it involves tumors that do not carry the HER2/neu gene or receptors to estrogen or progesterone. This means that the estrogen-blocking drug tamoxifen will not help them, nor will Herceptin, which targets HER2/neu. There are currently no treatments specifically for women with triple-negative disease, Woodward said.

Large clinical trials will be necessary, Woodward added, to fully understand whether black women's tumor biology is indeed different, and if so how to treat it more effectively.

SOURCE: Cancer, December 1, 2006.

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