Black women have a higher risk of breast cancer than white women

BMJ 19 January 2008, Volume 336, Roger Dobson

Black women in Britain develop breast cancer up to 21 years earlier than white women. They are seen at a median age of 46—four years before routine NHS screening for the disease starts—compared with 67 for white women, according to the first published data on breast cancer presentation in black women (British Journal of Cancer; doi: 10.1038/sj.bjc.6604174).

Among women with smaller tumours (less than 2 cm), black women were nearly three times as likely to die of their disease (hazard ratio 2.90, 95% CI 0.98 to 8.60, P=0.05).

"Our findings could have major implications for the biology of breast cancer and the detection and treatment of the disease in black women," say the authors. "It is crucial to target this group of women to raise their awareness regarding the risks of breast cancer, the likelihood of early age at presentation, and the importance of self-examination."

The authors, from Barts and The London, Queen Mary’s School of Medicine and Dentistry, and Wolfson Institute of Preventive Medicine, say that until now there have been no data on the patterns of breast cancer in British black women.

"Since there are no published data on breast cancer in British black women, we sought to determine whether, like African-American women, they present at a younger age with biologically distinct disease patterns,’’ they say.

For the study, the authors looked at women presenting at the Homerton University Hospital, Hackney, between 1994 and 2005 with a diagnosis of invasive breast cancer. Of the 445 patients with a new diagnosis of breast cancer between 1994 and 2005, 102 were black and 191 white British women.

Results show big differences in age at diagnosis. Black patients were significantly younger (median 46 v 67 years, P=0.001). No other common cancer in the same population of black women was as common in younger women.

A higher proportion of black women had grade 3 tumours, lymph node positive disease, negative oestrogen receptor and progesterone receptor status, and basal-like (triple negative status) tumours. Some 62% of black women had grade 3 tumours, compared with 42% of white patients.

The authors say there is no evidence that the results are due to late presentation or inequalities in the receipt of therapy. A data review showed that black women received more adjuvant therapy—chemotherapy, radiotherapy, and hormone therapy—than their white counterparts.

"Breast cancers arising in young black women appear to be biologically different, an effect not attributable simply to the young age of affected individuals," say the authors, who add that while tumours in younger black women are considerably more aggressive, in women over 60, whatever their ethnic origin, breast tumours show similar behaviour.

The authors point out that the NHS breast screening programme is offered to all women up to age 70, starting at 50, four years later than the median age for presentation of the black women in the study.

"Alterations to the screening services offered to black populations might be considered to better reflect the incidence patterns for this group, much as it has been for those individuals with a family history deemed to be at risk of breast cancer at a younger age," says the report. "Additional resources required for the screening of black women from age 40 or 45 would be modest, but there could be organisational difficulties in identifying the relevant population for invitation."

I think this is bullshit.

Can you clarify exactly what it is that you find wrong with this article?

I used to work in an oncology unit in a London hospital a couple of years ago and I did notice first hand that the African-Carribean women treated there tended to be younger than their white counterparts. These women were in their 30s. The researchers did not obtain the data from thin air.

I personally know of two women both under the age of 45 who are currently being treated for breast cancer.

Perhaps the title of the article is slightly misleading. The study is implying that black women are not more likely to develop the disease compared to white women but are rather more likely to develop it at a younger age.

I tend not to believe these kinds of 'studies', science & politics mix well.

I'm not quite sure what political motivations you think are behind this research but I really do not think we can afford to be dismissive of such data when it concerns us as black/African people. As I also pointed out, even before this subject was investigated, from my own professional and personal experience I too have noticed that breast cancer seems to present at an earlier age for black/African women. When breast cancer screening is offered from the age of 50 years onwards on the National Health Service and the average age at presentation is 46 years for us, we need to be concerned. At the very least, I think this topic deserves some sort of discussion or debate rather than a flippant dismissal.

One of the people involved in the research discussed the findings on BBC London on Sunday. Click 'Listen Again' for the 'Dotun Adebayo on Sunday' show on BBC London to hear it. BBC - London - London Homepage

I read something in Time Magazine, that treatments for White women, do not work equally well on African (-American) women and Asian women. Something to do with breast density...

That is true. The types of breast cancer found in younger black women tend to be more aggressive and do not respond as well to more conventional chemotherapy.

Cancer Research UK provides useful information on body awareness and breast self examination Cancer Research UK : Check your breasts for signs of breast cancer

If you are a woman, your breasts will change in size and shape at different times in your life and during the menstrual cycle. Knowing what your breasts feel like at different times of the month can help you notice any changes.

Be breast aware

Early detection of breast cancer can save lives. Follow the five point code:

1.know what is normal for you
2.look at and feel your breasts
3.know what changes to look for
4.report any changes without delay
5.go for breast screening if you are 50 or over

Check your breasts in a way that's comfortable for you, perhaps in the bath or shower.

Changes to look out for

It is often women themselves who first notice their breast cancer. Look for:

changes in the size, shape or feel of your breasts
a new lump or thickening in one breast or armpit
puckering, dimpling or redness of the skin
changes in the position of the nipple or nipple discharge
new pain or discomfort that is only on one side.

There may be many reasons for the change other than breast cancer. But report anything unusual to your doctor straight away.

Find out more
For more information, visit the NHS Breast Awareness page. There you can also download or order the leaflet 'Be Breast Aware', produced by the NHS Breast Screening Programme together with Cancer Research UK.

Come on now. Don't tell me that you think this is racist in any way. It's just a fact of life. There have been plenty of studies on this.

My question is, if this is true, have they not come up with treatments or drugs which can be used to combat the cancers found in black women? Have they done studies to find successful trreatments?

Just wondering........

I don't think they have got as far as finding successful treatments yet in the UK but they may have in the US where similar results in African-American women have been known for several years.

Why would they make it up? Y'all can't think that everything is racist. We do generally have a higher rate of diseases than whites and other races. Mainly because of our diet. Too much fats and fried foods. And many of us are more obese than others. Diseases like high blood pressure, AIDS, and other STDs tend to be much higher in us than others. That's just a fact of life. It's not racism, BlackBrainChild.