Experts Have Discovered Why African-American Women With Breast Cancer Have Poor Prognosis

The scientific reason behind the pooper prognosis of estrogen-receptor positive (ER+) breast cancer in African-American women compared to European-Americans had been identified. The study, which will be presented at the American Association for Cancer Research (AACR) Annual Meeting 2015, suggests that the poor outcomes may be due to the increased survival mechanisms inside the cancer cells.

The researchers from the Georgetown Lombardi Comprehensive Cancer Center said that the tumours found in African-American women are less sensitive to tamoxifen. Tamoxifen is a drug usually administered to treat ER+ breast cancer. This is said to be due to the high activities of the "unfolded protein response," or UPR.

If an anti-cancer drug is administered, the cancer cell may be stressed and cause the UPR to activate. This mechanism will then trigger the cancer cells to quiet down and be vulnerable to an attack, says the study leader, Ayesha Shajahan-Haq, also an oncology research assistant professor. She adds that the the team was able to discover that the UPR pro-survival pathway and the genes along the pathways are highly activated among African-American women compared to other races - finding that can explain why these women are resistant to common treatment.

The incidence of ER+ breast cancers are high at 70 percent. ER+ breast cancers require estrogen to thrive; this is why most cancer therapies act to prevent estrogen to reach the cancer cells. However, approximately 50 percent of cancers becomes resistant. African-American women with ER+ breast cancers were administered with the same treatment given to European-Americans, but the former had the worse progression-free and overall survival outcomes.

The findings of the study do not present the entire clinical picture of racial factors associated with ER+ breast cancers, Shajahan-Haq says. What they are able to demonstrate is the elevated resistance of African-American patients to anti-cancer therapy and the factors affecting such finding. "Biology may not be the only factor contributing to the racial disparities in outcome in the general public. Factors such as access to mammography, follow-up care or treatment, income status and other social factors have also been shown to contribute to disparities in outcome," she adds. She closes by saying that future treatment focusing on the pro-survival UPR pathway could help decrease resistance and provide a better treatment regimen for African-American women with ER+ breast cancer.

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