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Black Women Genetically Prone to Aggressive Tumors

Racial differences in breast cancer linked to genes

Black women are more likely to develop aggressive forms of breast cancer than white women because of genetic differences in the tumors, a new study suggests.

The finding that genetic characteristics of more aggressive tumors may be more prevalent among black women could help explain racial differences in survival rates, notes HealthDay. The researchers said their findings could help scientists develop more targeted treatments for the disease.

Previous studies have already found that, compared with white women, black women have a higher prevalence of breast cancers that do not respond to hormone therapy — so-called "triple-negative" breast cancers.

Now, researchers report that black breast cancer patients also have a "significantly higher prevalence of the TP53 driver mutation, basal tumor subtype, and greater genomic diversity within tumors, all of which suggest more aggressive tumor biology," said the study's lead author, Dr. Tanya Keenan of Massachusetts General Hospital Cancer Center in Boston. "The higher risk of tumor recurrence that we observed among African-American women was reduced when controlling for those factors, suggesting that these genomic differences contribute, at least partly, to the known racial disparity in the survival of African-American and Caucasian breast cancer patients."

Advancements in the diagnosis and treatment of breast cancer have reduced the overall death rate from the disease, but this positive trend is less apparent among black women, the researchers said. Black women with breast cancer in the United States are 40% more likely to die from their disease than white women, a disparity that can't be explained solely by social and economic factors, such as income, insurance, and access to care.

For the study, the investigators analyzed genetic differences between the tumors of 105 black women and 664 white women diagnosed with cancer between 1988 and 2013 to determine how genes could influence cancer recurrence.

The same five tumor-specific mutations were most prevalent among all of the women included in the study, but more black women had tumors driven by TP53 mutation. Women with this mutation were more likely to suffer a recurrence and their relapse also occurred more quickly, according to the study, which was published online in the Journal of Clinical Oncology.

Meanwhile, white women more often had tumors with the PIK3CA mutation. Overall, however, black women had more mutations within each tumor and greater prevalence of mutations associated with more aggressive tumors, the findings showed.

"Our study adds important pieces to the puzzle of why African-American women with breast cancer are less likely to survive," said the study's senior author, Aditya Bardia, an assistant professor of medicine at Harvard Medical School and attending physician at the Massachusetts General Hospital Cancer Center. "If our findings are confirmed by additional studies, they may open doors to the development of targeted therapies against the tumor subtypes more likely to affect African-Americans, and potentially help reduce racial disparities in breast cancer."

Source: HealthDay; September 21, 2015.

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