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British Journal of Cancer (2008) 98, 277-281.
doi:10.1038/sj.bjc.6604174 www.bjcancer.com Published online 8 January 2008
Early onset of breast cancer in a group of British black women
R L Bowen1, S W Duffy2, D A Ryan3, I R Hart1 and J L Jones1
1Centre for Tumour Biology, Institute of Cancer and CR-UK Clinical Centre, Barts and The London, Queen Mary's School of Medicine and Dentistry, John Vane Science Centre, Charterhouse Square, London EC1M 6BQ, UK
2Cancer Research UK, Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK
3Department of Histopathology, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK
Correspondence to: Dr RL Bowen, E-mail: rebecca.bowen@cancer.org.uk
Ethics Committee Approval: St Mary's REC, 06/Q0403/162
Revised 21 November 2007; accepted 30 November 2007; published online 8 January 2008
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. The method involved a retrospective review of breast cancer to compare age distributions and clinicopathological features between black women and white women in the UK, while controlling for socioeconomic status. All women presented with invasive breast cancer, between 1994 and 2005, to a single East London hospital. Black patients presented significantly younger (median age of 46 years), than white patients (median age of 67 years (P=0.001)). No significant differences between black and white population structures were identified. Black women had a higher frequency of grade 3 tumours, lymph node-positive disease, negative oestrogen receptor and progesterone receptor status and basal-like (triple negative status) tumours. There were no differences in stage at presentation; however, for tumours of
2 cm, black patients had poorer survival than white patients (HR=2.90, 95% CI 0.98-8.60, P=0.05). Black women presented, on average, 21 years younger than white women. Tumours in younger women were considerably more aggressive in the black population, more likely to be basal-like, and among women with smaller tumours, black women were more than twice as likely to die of their disease. There were no disparities in socioeconomic status or treatment received. Our findings could have major implications for the biology of breast cancer and the detection and treatment of the disease in black women.Keywords: British black women; invasive breast cancer; age distributions; clinicopathological features; triple negative; socioeconomic status
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