Click here for YNHH home page.


Sign up for HealthLINK.

Can we help?

Follow up on this month's He@lthLINK

 

He@lthLINKs

Site Contents


Phone Numbers

Directory assistance
(203) 688-4242

Patient information
(203) 688-4177

Adult emergency
(203) 688-2222

Children's emergency
(203) 688-3333

Admitting
(203) 688-2221

Children's admitting
(203) 688-3331

Psychiatric admitting
(203) 688-9907



Mailing address:
Yale-New Haven Hospital
20 York Street
New Haven, CT
06510-3202




Site Contents


   Yale-New Haven Hospital, New Haven, Connecticut, USA HealthLINK: Cancer

October 11, 2004

News this month
Genetic mutation linked to more aggressive breast tumors in African-American women

Doctors have long known that African-American women are diagnosed with breast cancer less often than white women, but when they are, the disease is more likely to be fatal. A recent Yale University School of Medicine study sheds some light on the question of why this is so: African-American women are four times more likely than white women to have a genetic mutation that makes their breast tumors much more aggressive, which means faster growing and more deadly.

African-American women are diagnosed with breast cancer less often than white women, but when they are, the disease is more likely to be fatal.

A mutation in gene p53
To better understand the differences between breast cancer in African-American and white women, Beth A. Jones, MD, Yale assistant professor of epidemiology and public health, and her team studied the tumors of 145 African-American women and 177 white women diagnosed between 1987 and 1989. They found the African-American women were four times more likely to show significant alterations in the tumor-suppressing p53 gene.

Tumor suppressor genes are normal genes whose absence can lead to cancer. If a pair of tumor suppressor genes is either lost from a cell or inactivated by mutation, their functional absence can allow cancer to develop. Individuals who inherit an increased risk of developing cancer often have one defective tumor suppressor gene. There are about 10 identified suppressor genes.

In the study, however, the prevalence of other cancer-related genes didn't differ significantly between the two groups of women studied.

Understanding the underlying biological mechanisms [that lead to poorer outcomes in African-American women] is a major breakthrough.

A biological reason
Until now, doctors didn't know if there was any biological cause for the differences in breast cancer between African-American and white women. They knew that socio-economic factors often were to blame, because African-American women, on average, don't have early detection screening as often as white women, or in some cases, poor access to health care. Nutrition also was thought to play a role.

Dr. Jones said that while many factors contribute to the relatively poor outcome for some African-American breast cancer patients, understanding the underlying biological mechanisms is a major breakthrough.

Hope for the future
“Our goal is to continue to illuminate the reasons for the differences, so we can ultimately develop prevention strategies and tailor treatments more effectively,” said Dr. Jones.

Physician Referral Online

A free and confidential service
of Yale-New Haven Hospital.

Physician Referral Online
Using your own criteria, you can request information from a database of more than 1,000 area physicians who have registered to participate.

Request an appointment
We would be happy to assist you in scheduling an appointment with a member of the hospital's medical staff. Use the link above or call:

203-688-2000
or toll free
1-888-700-6543
to talk with a referral coordinator.





2002 Best Hospital--U.S. News Online

Yale-New Haven was recognized this year by U.S. News & World Report for its cancer services.
Donald Lannin, MD

Answers to “why” may lead to better tailored treatments for breast cancer

All breast cancers are not created equal. Some are slow growing, while others are more aggressive and deadly, advancing at faster rates.

“[African-American women] are often diagnosed at a younger age than other women and have a higher mortality rate.”

African-American women get breast cancer less often than white women, but if they are diagnosed with the disease, it is often more advanced and more aggressive. They are often diagnosed at a younger age than other women and have a higher mortality rate. This has puzzled doctors.

Looking for answers
Until now, we had guessed that socio-economic factors were somewhat to blame. Were African-American women getting early screening mammography? Did they have the same access to health care their white counterparts had? How were their nutrition and other health factors? But all this aside, even African-American women who saw their doctors regularly and had annual mammograms, but had breast cancer, tended to be diagnosed with more aggressive forms of the disease.

Quite often, the women had higher-grade tumors and cancers that were hormone receptor-negative. Hormone receptor-negative signals a bad type of cancer. Since healthy breast tissue has hormone receptor cells, if a tumor doesn't have receptor cells, it is that much farther away from a normal cell. With all these differences in breast cancer severity and mortality between the races, we continued to ask, “Why?”

A biological component
This is an excellent study because it helps answer some of our questions. We now know one underlying biological component to the more aggressive cancer, and that opens the door to a broader understanding of the disease. More important, in the future it might lead us to develop better tailored treatments.

In a nutshell: This study tells us that a genetic mutation to the tumor suppressor gene p53 is one biological explanation. While it's very complicated, basically tumor suppressor genes help keep cancer away. P53 is one of about 10 genes that help suppress all types of cancer.

“[The] p53 gene has been found to be altered in African-American women four times as often as white women.”

New tumor suppressor genes are being identified all the time. In most cancerous cells, a suppressor gene has been lost or damaged. This p53 gene has been found to be altered in African-American women four times as often as white women. If the gene is mutated, it can't do its job to suppress cancer.

Should I be tested?
Some women may be wondering whether they should be tested to see if their p53 gene is mutated. I don't think so. It's not a routine test, and knowing whether your tumor has the mutation wouldn't affect your treatment or outcome at this time. It's more of a first step for doctors to know who gets the more aggressive types of breast cancer.

More research needed
Over the past 15 years, we have helped lower the breast cancer mortality rate in white women but not in African-American women. When we can better understand the biological causes, we might be able to tailor treatments that fit the type of cancer.

The study is also creating a lot of buzz. But while this study is exciting, as with any study, it points out the need for further answers. A fair amount of money is spent each year on breast cancer research, but it's never enough. It's my hope that subsequent studies look at the difference in survival rates between the groups of women and look for other similar biological markers. With that information, we can offer women more promise for the future.

Early detection key
This study shouldn't change a thing women do—they still need to abide by their doctors' recommendations for screenings and talk to their doctors about any concerns they may have. Early detection remains the best defense.

Donald Lannin, MD, is co-director of the Yale-New Haven Breast Center and a professor of surgical oncology at Yale University School of Medicine.


Spacer.
Subscribe to HealthLink.

 

Other related links.

Copyright 1999-2008.
Top of Page. Y-NHH. YNHHS. Site Editor.

Home page
Staff directory
Directions and parking
Online resources
Yale New Haven Health System		   Need a doctor?
Search
Comments
Top of page
Yale-New Haven Medical Center

Home page URL: http://www.ynhh.org

All information is intended for your general knowledge and is not a substitute for medical advice or treatment for specific medical conditions. You should seek prompt medical care for any specific health issues and consult your physician before starting a new fitness regimen.