Early onset of breast carcinoma in African American women with poor prognostic factors

The purpose of this study was to determine prognostic significance of age a nd race as independent variables and to see role of age at the onset of bre ast carcinoma. A retrospective study was conducted of African American and white women with breast cancer treated at SUNY-Health Science Center Brookl yn and Kings County Hospital Center from 1983 to 1993. The objective was to analyze the differences in patterns of disease onset, as related to age an d prognostic factors. A total of 738 patients were analyzed for race-adjust ed comparison of stage, grade, disease-free survival, and median survival. Age at the time of diagnosis was analyzed to conduct age-specific compariso ns of African American (AA) and white patients. The multivariate analysis i ndicated that AA women develop breast cancer 10 years earlier than white wo men (p = 0.00001). Corrected by stage and grade, i.e., chi(2) test for stag e-by-stage and grade-by-grade analysis has revealed that the AA women prese nt with higher stage (p = 0.009), increased number of positive nodes (p = 0 .00007), and more estrogen receptor/progesterone receptor-negative tumors ( p = 0.005). Further studies are required to probe into the etiologic possib ilities of this significant difference. The important contributing factors could be hormonal, genetic, environmental, and socioeconomic. Obesity and d ietary factors also need to be evaluated, Further studies to explore geneti c susceptibility by ploidy is recommended to explain this significant diffe rence. We conclude that the onset of breast cancer among AA women occurs at a significantly younger age than in white women, and their prognostic fact ors are poorer.