Hispanic women and breast cancer: An understudied group

• Cancer • • Breast Cancer • Feb 05, 09

Data from the ELLA Binational Breast Cancer Study will be released for the first time at the American Association for Cancer Research Conference on the Science of Cancer Health Disparities in Carefree, Arizona.

“Hispanics are the fastest-growing minority group in the United States, but little is known about their risk for breast cancer,” said Elena Martinez, Ph.D., professor of epidemiology at The University of Arizona Mel and Enid Zuckerman College of Public Health and co-leader of the Cancer Prevention and Control Program at the Arizona Cancer Center, Tucson. “The study recruited women who were recently diagnosed with invasive breast cancer living in the United States and in Mexico. We hope to understand more about what puts these women at risk for specific types of breast cancer.”

Martinez will moderate a press conference in both English and Spanish at the Science of Cancer Health Disparities meeting. The English-language press conference will take place at 10:00 a.m. MST on Wednesday, February 4, while the Spanish-language press conference will take place at 11:00 a.m. MST on the same day. Reporters unable to attend in person can call in to each conference at 888-282-7404.

“We are just beginning to scratch the surface of our understanding of this disease in Hispanic women, but we are noticing a difference between Mexican-born Hispanics and American-born Hispanics,” said Martinez.

The press conference will feature three abstracts from the ELLA Binational Breast Cancer Study and one additional abstract on Hispanics from the San Francisco Bay Area Breast Cancer Study.

#A78. The ELLA Binational Breast Cancer Study: Risk factor and tumor marker profile in women of Mexican ancestry.

The first abstract will be presented by Maria M. Meza-Montenegro, Ph.D., a research professor at the Instituto Technológico de Sonora in Mexico, which will outline the profile of the women who enrolled in the ELLA Binational Breast Cancer Study.

The researchers have recruited a total of 652 women including 309 in the United States and 343 in Mexico. Women in Mexico are significantly older at diagnosis at 53.8 years compared with 48.7 years in the United States. Reproductive data showed a similar age at menarche, menopause and first pregnancy. However, the number of live births was higher in Mexico at 3.7 vs. 3.2 in the United States.

Prevalence of family history of breast cancer was significantly higher in the United States at 18.1 percent compared with 6.2 percent in Mexico.

Body mass index was similar, and high, in both groups at an average of about 29. “This abstract sets the stage for what we want to talk about because these differences and similarities could prove to be important with further research,” said Martinez.

#A55. Breast cancer detection and screening mammography in Mexican-American women: Findings from the ELLA Binational Breast Cancer Study.

A subsequent abstract, presented by Rachel Zenuk, a graduate student at The University of Arizona Mel and Enid Zuckerman College of Public Health, suggests that breast cancer may be more aggressive in Hispanic women because they are waiting longer to receive treatment.

The data show that 67 percent of breast cancer was found through self detection, while only 23 percent was found using screening mammography and six percent through a clinical examination. Among Hispanic women born in the United States, the rate of mammography use was 83 percent compared with 62 percent among women not born in the United States.

After noticing a change in their breasts, 49 percent of women reported waiting one month or more to seek medical attention. The most common reason was that these women did not have access to insurance or could not afford medical care.

“Hispanics have the highest levels of lack of insurance of any minority group, and because of that they are hesitating to get the care they need,” said Martinez.

#PR-4. Increased odds of family history for triple-negative breast cancer in Mexican-American but not African-American women.

A final ELLA Binational Breast Cancer Study abstract, presented by Betsy C. Wertheim, M.S., an assistant scientific investigator in the Cancer Prevention and Control Program at the Arizona Cancer Center, found that having a family history of breast cancer increased the risk of triple-negative breast cancer in Hispanic women but not in African-American women.

Specifically, if Hispanic women had a family history of breast cancer they were at 2.2-fold increased risk for triple-negative breast cancer. These women were also six times more likely to develop triple-negative breast cancer at a young age, but no such association was seen for African-American women.

Wertheim said this risk was confined to Hispanics who were born in Mexico; no such increased risk was seen among American-born Hispanic women.

“It was driven by geography, so we suspect that there is some combination of genetics and environment at play here. What exactly that is, we can’t really say yet,” said Wertheim.

#PR-5. Breast cancer risk factors in U.S.-born and foreign-born Hispanic women from the San Francisco Bay Area.

A final study, the San Francisco Bay Area Breast Cancer Study, presented by Esther John, Ph.D., a research scientist and epidemiologist at the Northern California Cancer Center, compared known breast cancer risk factors in foreign-born Hispanic women and Hispanic women born in the United States.

Among Hispanic women without breast cancer, they found that U.S.-born Hispanic women were more likely to have a family history of breast cancer, have menarche before age 12, use hormone replacement therapy, be obese and consume alcohol. All of these are known risk factors for breast cancer. By contrast, foreign-born Hispanic women without breast cancer had a larger number of children, a longer duration of breast feeding, more physical activity and a higher fiber intake. All of these factors are known to decrease breast cancer.

“Foreign-born Hispanic women have a lower risk for breast cancer than U.S.-born Hispanic women, and differences in reproductive and lifestyle factors explain some of the difference in risk, but not all of it,” said John. “What is interesting is that over the long term, foreign-born Hispanic immigrants adopt behaviors that place them at greater risk for breast cancer.”

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