African-American women are more likely than all other women to die from breast cancer, and according to research presented this week at the annual meeting of the American Association for Cancer Research, doctors have gained more insight as to why that disparity exists.


For more than six years, researchers at the Kaiser Permanente Division of Research in Oakland, Calif. followed nearly 1,700 breast cancer patients who had been treated for four different subtypes of breast cancer, including luminal A, luminal B, basal-like or HER2-enriched cancer. During that period, about 500 of the patients had died, nearly 300 of them from breast cancer, researchers say.


Among them, black patients were nearly twice as likely as white patients to have died from breast cancer, regardless of the cancer subtype, findings that turn traditional thinking about black women and breast cancer on its head.


"The results seem to indicate that although African-American women are more likely to be diagnosed with less treatable subtypes of breast cancer compared with white women, it is not the only reason they have worse breast cancer mortality," said Candyce Kroenke, M.P.H., Sc.D., research scientist at Kaiser.


The Black-White difference in breast cancer survival rates has been traditionally attributed to the fact that black women are more commonly diagnosed with less treatable tumor subtypes, such as the hard-to-treat triple-negative strain. But even though triple-negative diagnoses prevailed in her study and the likelihood of black women developing the most-treatable luminal A subtype did not, Kroenke says that poor prognosis among blacks appeared consistent across the board.


"African-Americans with breast cancer appeared to have a poorer prognosis regardless of subtype," Kroenke said. "It seems from our data that the black–white breast cancer survival difference cannot be explained entirely by variable breast cancer subtype diagnosis," she went on to say.


Recent genetic profiling has suggested that not all cancer subtypes are created equal and both the tumor makeup and methods for treating them may vary by race.


Yet others maintain that factors such as poverty, silence and racial inequities -- not genetics -- are responsible for high mortality rates. Their efforts have focused less on treatment than on awareness and eliminating cultural barriers to seeking care.


Earlier on HuffPost:






  • One Treatment Does Not Fit All


    In a landmark series of <a href="http://www.huffingtonpost.com/2012/09/24/breast-cancer-gene-study-new-treatment-black-women_n_1910142.html">studies that honed in on four major classes of breast cancer</a> last month, researchers have been able to provide clues as to why the disease differs between races.

    At North Shore-LIJ Health System's Monter Cancer Center, researchers found that <a href="http://www.huffingtonpost.com/2012/06/06/breast-cancer-genetics-race-therapy-treatment_n_1574724.html">Caucasian women may carry microRNAs that protect against breast cancer, genes that African American women don't carry.</a>

    The finding not only explains why cancer outcomes are often different between black and white women, it also supports the importance of personalized treatment for cancer that focuses on the genetic make-up of tumors, rather than a one-treatment-fits-all approach.




  • "D" Stands For Decreased Risk


    A study published in the journal <em>Breast Cancer Research</em> in April revealed <a href="http://www.huffingtonpost.com/2012/04/08/vitamin-d-may-reduce-breast-cancer-in-black-women-study_n_1411599.html">African-American women with the highest levels of vitamin D also had a specific variation in the vitamin D receptor that cut their breast cancer risk in half</a>, compared to women without it.

    About a third of African Americans are vitamin D deficient, however, and melanin in the skin make it harder for many to get enough.

    Along with a healthy does of sunshine, experts recommend a vitamin D supplement of 600 IU per day.




  • Even Moderate Exercise Helps


    In June, researchers at University of North Carolina in Chapel Hill found that women who<a href="http://www.huffingtonpost.com/2012/06/25/exercise-breast-cancer-risk-moderate_n_1619175.html"> exercise between 10 and 19 hours each week had a 30 percent lower risk of breast cancer</a>. And there isn't a need to break a serious sweat either. <em>All</em> levels of exercise intensity were linked with a decreased risk, the study authors said.




  • Regular Screening Are Key To Closing Racial Gaps


    According to a study published in <em>Breast Cancer Research</em> in August, <a href="http://www.sciencedaily.com/releases/2012/09/120925153327.htm">mammograms may be the key to closing the breast cancer gap between black and white women.</a> When study participants received regular breast screening, "there was no difference in the rate of how many of them presented in the disease's later stages," researchers found. "This study reinforces the fact that racial gaps in breast cancer outcomes can be improved," said lead author Dr. Paula Grabler, an assistant professor of radiology at Northwestern University Feinberg School of Medicine and a radiologist at Northwestern Memorial Hospital.




  • Affordable Care Is Within Reach


    In a <a href="http://thehill.com/blogs/healthwatch/public-global-health/259519-obama-sebelius-healthcare-law-is-fighting-breast-cancer">commemoration of Breast Cancer Awareness month Monday, President Obama and Health and Human Services Secretary Kathleen Sebelius</a> credited the Affordable Care Act with bringing on "a new day for women's health and the fight against breast cancer." According to Sebelius, the healthcare law "means that women can get the potentially life-saving services they need to detect breast cancer before it spreads, without worrying how a copay would affect their family budget."




  • Existing Treatments Work


    A September study by Washington University researchers suggests basal-like breast tumors, one of the deadliest forms of the disease that has been shown to disproportionately affect younger women and those who are African-American, <a href="http://www.huffingtonpost.com/2012/09/24/breast-cancer-gene-study-new-treatment-black-women_n_1910142.html">have a similar genetic makeup to ovarian tumors and could potentially be treated with the same drugs. </a> This means some women may be able to forgo less effective treatments that are typically used for basal-like tumors and have been know to cause heart problems and lead to the development of other cancers, including leukemia.




  • Triple-Negative Treatments Are Closer


    The notoriously fatal triple-negative breast cancer (TNBC) may have met its match, according to researchers from Memorial Sloan-Kettering Cancer Center in New York who found that a form of the small pox virus can be used against TBNC. In the study released this week, researchers found that a certain form of smallpox vaccine was able to kill 90 percent of TBNC cells in four days of treatment. It also inhibited blood flow to the cancer stopping its spread. TNBC is found in about 15 out of every 100 cases and is more likely to occur in Hispanics and African Americans.