Black women get breast cancer two decades earlier than white women
Black British women in Hackney, East London, are diagnosed with breast cancer 21 years younger than white British women, according to a Cancer Research UK study published online in the British Journal of Cancer.
In the first UK study to look at the patterns of breast cancer in black British women, the researchers studied 102 black women and 191 white women diagnosed with breast cancer at Homerton University Hospital in Hackney, East London, between 1994 and 2005. They found the black patients were diagnosed with breast cancer at an average age of 46 while the white patients were diagnosed at an average age of 67.
Researchers based at the Institute of Cancer and Cancer Research UK clinical centre at Barts and the London School of Medicine and Dentistry also found that survival was poorer among black women with smaller tumours. In addition, their initial findings suggest that tumours in the younger black patients were more likely to be aggressive, and a higher proportion of tumours were basal-like - meaning they were less likely to respond to newer types of targeted breast cancer treatments like Herceptin.
If these results are confirmed in larger studies, the findings could have implications for diagnosis, screening and treatment of black British breast cancer patients in the future.
Study author Dr Rebecca Bowen, said: "Twenty five per cent of all breast cancer cases diagnosed in London during the period studied were in women aged 45 or younger - but this figure rose to 45 per cent among the black population in Hackney. We think the differences in the way tumours of black and white women behave can be put down to the biological differences between the two ethnic groups. We're now trying to find out why the tumours are so different so that we can develop new treatments to target the aggressive forms of breast cancer seen in young black women."
Until recently, UK cancer registries have not collected ethnicity data routinely, but incidence of breast cancer among black British women is thought to be lower than the white population. American research has suggested that African-American women get breast cancer at a younger age and at a more advanced stage - but this is the first UK study to draw these conclusions.
Dr Bowen added: "We've just received funding for the next stage of our research which will allow us to determine the type of cancers these women are getting at this young age. It's important that we use the information learnt from this study to raise awareness of breast cancer risk factors and the importance of early detection among the black population."
Dr Lesley Walker, Cancer Research UK's director of cancer information, said: "This is very interesting research. The fact that black women are being diagnosed with breast cancer at a much younger age than white women is clearly worrying. If these results are confirmed in follow-up studies, it might be appropriate to alter screening services offered to black women to better reflect the age at which they are diagnosed with breast cancer - but at the moment it’s too early to suggest any changes to the screening programme because the study was so small.
"These findings highlight the need for all women to be breast aware, report any changes to the doctor promptly and attend screening appointments when invited, as early detection is important for successful treatment."
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Notes to Editor
Early onset of breast cancer in a group of British black women. RL Bowen et al. 2008. British Journal of Cancer.
The black population in this study were from black African or black Caribbean descent. Women who reported that they were of mixed race were excluded from the study and women from other ethnic groups - including Greek, Jewish, Turkish, Chinese/Vietnamese, Arabic and Indian - were also excluded from the study. The white population in this study self reported as white British.
The study was supported by Cancer Research UK and Barts and The London Charitable Foundation.
Breast cancer is the most common cancer in the UK and 44,000 women are diagnosed with the disease each year. The lifetime risk of being diagnosed with breast cancer is 1 in 9. The biggest risk factor for breast cancer is age and four out of five new cases are diagnosed in women aged 50 and over. Other risk factors include having children later in life, having few or no children, a strong family history of the disease, obesity - especially after the menopause - and alcohol intake. The five-year survival rate for breast cancer is 80 per cent and two thirds of women now survive for 20 years or more.
Breast cancer screening
In the UK women aged between 50 and 70 are offered screening every three years. The programme is gradually being extended to include women aged from 47 and up to 73 years of age. Screening involves taking x-rays of the breasts - a mammography.
Breast screening can show cancers at an early stage. When changes are found early, there is an excellent chance of successfully treatment.
Breast screening is effective but it's not perfect. Women would keep a check on their breasts even if they have been for screening.
Screening Matters is Cancer Research UK's new campaign calling on politicians to get more people into cancer screening programmes across the UK and to make sure the programmes are as good as they can be. The campaign also calls on the public to attend screening when invited, and encourage friends and family to do the same.
Be 'breast aware' and follow the five point code:
- Know what is normal for you
- Look at and feel your breasts
- Know what changes to look for
- Report any changes without delay
- Go for breast screening when invited
Breasts may feel different depending on the time of the month and the stage of life. When you know how they normally look and feel, you will be able to spot any unusual changes.
What changes to look for
It is often women themselves who first notice their breast cancer. Most changes are not caused by cancer, but it is very important to report anything unusual to the doctor. Look for:
- Changes in the size, shape or feel of your breasts
- A new lump or thickening in one breast or armpit
- Any puckering, dimpling or redness of the skin
- Changes in the position of the nipple, a rash or nipple discharge
- Pain or discomfort that is new to you and felt only on one side
For more information about cancer visit our patient information website CancerHelp UK or contact Cancer Research UK's information nurses on 0800 800 4040 (freephone) - the line is staffed from 9am to 5pm Monday to Friday.
Barts and the London School of Medicine and Dentistry
Barts and The London School of Medicine and Dentistry offers international levels of excellence in research and teaching while serving a population of unrivalled diversity amongst which cases of diabetes, hypertension, heart disease, TB, oral disease and cancers are prevalent, within east London and the wider Thames Gateway. Through partnership with our linked trusts, notably Barts and The London NHS Trust, and our associated University Hospital trusts - Homerton, Newham, Whipps Cross and Queen’s - the School's research and teaching is informed by an exceptionally wide ranging and stimulating clinical environment.
At the heart of the School's mission lies world class research, the result of a focused programme of recruitment of leading research groups from the UK and abroad and a £100 million investment in state-of-the-art facilities. Research is focused on translational research, cancer, cardiology, clinical pharmacology, inflammation, infectious diseases, stem cells, dermatology, gastroenterology, haematology, diabetes, neuroscience, surgery and dentistry.
The School is nationally and internationally recognised for research in these areas, reflected in the £40 million it attracts annually in research income. Its fundamental mission, with its partner NHS Trusts, and other partner organisations such as Cancer Research UK, is to ensure that that the best possible clinical service is underpinned by the very latest developments in scientific and clinical teaching, training and research.
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