Breast Cancer: It’s more aggressive in African-American women

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Breast cancer is a major killer of African-American women. According to the American Cancer Society, 20,000 Black women were diagnosed with the disease each year between 1995 and 1999. Of those diagnosed, 5,700 died each year. While breast cancer is not as prevalent in Black men, they, too, can get it. In 2004 to date, 470 men of varying races have died from the disease, the society says.

The most common forms of breast cancer in all women are ductal. Eighty percent of breast cancers come from the milk duct. The other type is lobular (from the gland that makes milk), which accounts for 10 percent to 15 percent of breast cancer cases. The disease is more aggressive in African-American women than in white women. “Breast cancer tends to be poorly differentiated in African-American women, which means it has the potential to spread to other organs,” says Dr. Bert Peterson Jr., chief of the Breast Cancer Division at Hackensack University Medical Center in Hackensack, N.J. “Part of the reason for the more aggressive breast cancer is that African-American women tend to get breast cancers that are estrogen and progesterone receptor-negative. If the receptors are there it’s good, because the tumors will respond to treatment. We postulate that African-American women don’t metabolize sex hormones like estrogen and testosterone as rapidly as white women do. That can contribute to more aggressive forms of breast cancer and prostate cancer in Black men,” Dr. Peterson says.

Dr. Peterson is presently involved in a study of the role of estrogen metabolism genes, focusing on the differences between African-American and white women. Other issues, such as where one seeks health care, play a part in the high rate of advanced breast cancer in Black women, he says. “Many African-American patients don’t go to major medical centers. They go to smaller clinics where mammograms are read improperly and the tumor is missed,” Dr. Peterson says.

Black men can detect cancer if they feel a lump on the chest when showering. Unfortunately, men tend to ignore the lump until discharge comes from the nipple, Dr. Peterson says. By then the cancer is at an advanced stage.

Eating well—avoiding fatty foods and watching calorie intake—is the best way for Black women to reduce the risk of getting breast cancer. “Increased body fat in the teen years to the 20s increases your risk for developing breast cancer. Do moderate exercises to reduce body fat. Eating green, leafy, vegetables like spinach [as well as] broccoli, cauliflower and carrots is very good because they are antioxidants,” Dr. Peterson advises.

While the American Cancer Society advises women to begin yearly mammograms at age 40, Dr. Peterson recommends that Black women start at 35. He also advises starting clinical breast exams at age 25. MRIs are now being used to detect breast cancer at early stages. Other methods are ductal lavage—taking fluid from the nipple and milk duct to detect abnormal cells—and ductal endoscopy, using a small needlelike probe with a camera and going into the milk duct when a woman is having nipple discharge.

Support for breast cancer patients includes ACS’ Reach to Recovery program, where trained breast cancer survivors help newly diagnosed women through the experience. ACS also provides live operators 24 hours a day at 1-800-ACS-2345 for information on breast cancer. Operators speak 91 different languages.