Tuesday, February 06, 2007

An aggressive and hard-to-treat type of breast cancer known to plague young black women also disproportionately affects Latinas at higher rates

Dorsey Griffith:

Known as triple-negative or "basal-like" carcinomas, these tumors do not respond to the kind of newer, more targeted therapies that have curbed the spread of the disease in many women, lengthening their lives.

The findings are alarming not only because triple-negative cancers can be so deadly, but because many Latinas can face multiple barriers to obtaining comprehensive health care, from the most basic preventive screenings to sophisticated treatment regimens.

"Most of the women we work with -- low income, Spanish-speaking -- aren't even aware of what type of breast cancer they have," explained Ysabel Duron, who runs the grass-roots Latinas Contra Cancer organization in San Jose. "We haven't even gotten to the point where we can begin to talk about these complex diagnoses."

Triple-negative cancers are fairly rare; between 1999 and 2003, only 12 percent of California breast cancers were listed as such.

The term "triple negative" refers to tumors unlike those fed by the hormone estrogen. This means drugs that counter the effects of estrogen, such as Tamoxifen, Raloxifene or aromatase inhibitors, are useless against them.

Similarly, triple-negative cancers do not respond to the antibody drug Herceptin, developed against tumors that have too much of a cell surface protein called HER-2.

The triple-negative cancer finding, presented in December at the annual Breast Cancer Symposium in San Antonio, was the result of a collaboration between Sutter Cancer Center oncologist Vincent Caggiano and Monica Brown, an epidemiologist with the California Cancer Registry. The registry collects demographic and medical data on every California resident diagnosed with cancer.

Caggiano said while it was well-established that these aggressive breast tumors are far more prevalent among young, black women, scant data had been collected on tumor types in Latinas.

But because of its voluminous database, the Cancer Registry captured enough information on Latinas to detect the differences among groups.

Researchers looked at all cases of female invasive breast cancers in which a tumor type was reported from 1999 to 2003. Of the 51,074 cases, 12.5 percent were found to be triple-negative.

Of those, 11 percent were found in non-Hispanic white women, almost one-quarter were detected in black women, and 17 percent afflicted Latinas.

Overall, women with triple-negative cancers were more likely to live in low-income areas than other patients.

In general, "Hispanic women are at a much lower risk for breast cancer but are at risk for triple-negative breast cancer," said Brown of the Cancer Registry. "Why? That is what we don't know."

Younger black women who get breast cancer are far more likely than other afflicted women to have a particularly aggressive and lethal form of it


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