A racial disparity in mortality rates from breast cancer in the US first appeared in the 1970s coinciding with the introduction of mammography. The new research, published in The International Journal of Surgery, posits that the reason for this is not reduced access to medical care, but because surgery in pre-menopausal women could encourage growth of the cancer.
The average age of breast cancer diagnosis in African American women is 46, compared with 57 for European Americans.
A previous study by one of the article’s authors, Dr Isaac Gukas, of the University of East Anglia’s School of Medicine, Health Policy and Practice, identified a mean age of 43 for diagnosis of breast cancer in Nigerian women compared with a mean age of 64 in the United Kingdom. Over 70% of the Nigerian cases were aged below 50, compared to less than 20% of cases in the UK.
Further research published in 2005 suggested that those who underwent surgery for the disease before the menopause were more likely to relapse.
“Surgery to remove a primary tumour induces the formation of new blood vessels –known as angiogenesis. In pre-menopausal women who have high levels of oestrogen and other hormones, this may encourage the growth of the tumour,” said Dr Gukas.
“Early detection, through mammography, is more effective in post-menopausal women, and more white women are diagnosed after the menopause. This could explain the disparity in mortality.”
Dr Gukas’s experience as a clinician treating breast cancer in Africa led him to form the hypothesis that surgery-induced angiogenesis might explain the very high early mortality and generally poor outcome of patients in that part of the world.
He also noted that African patients presented with the disease in their early 40s, although no one has yet identified why black women get the disease earlier.
“We do not intend to oversimplify this subject, but it seems clear that at least part of the phenomenon of widening mortality along racial lines could be attributed to surgery leading to accelerated tumour growth in pre-menopausal women,” said Dr Gukas.
“We have the data from epidemiology. Now we need further research to confirm these observations before we explore any necessary changes in practice.”
The hypothesis, if proven, has implications for all women with breast cancer, especially pre-menopausal women – including the 20% of women in the UK who get breast cancer before the age of 50.
“We do not have enough evidence to alter treatment at present and younger women should not be deterred from having surgery. But, if further studies confirm our hypothesis, we may need to give them appropriate chemotherapy, including angiogenesis inhibitors, beforehand to ensure the best outcome,” added Dr Gukas.
The paper was jointly written by Dr Gukas, Dr Michael Retsky (lead author) of the Vascular Biology Program at the Children’s Hospital, Boston, USA, Romano Demicheli, of the Istituto Nazionale Tumori, Milan, and William Hrushesky of the University of South Carolina, USA.
Annie Ogden | alfa
The Great Unknown: Risk-Taking Behavior in Adolescents
19.01.2017 | Max-Planck-Institut für Bildungsforschung
A sudden drop in outdoor temperature increases the risk of respiratory infections
11.01.2017 | University of Gothenburg
An important step towards a completely new experimental access to quantum physics has been made at University of Konstanz. The team of scientists headed by...
Yersiniae cause severe intestinal infections. Studies using Yersinia pseudotuberculosis as a model organism aim to elucidate the infection mechanisms of these...
Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.
While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...
Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales
Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...
Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.
As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...
19.01.2017 | Event News
10.01.2017 | Event News
09.01.2017 | Event News
20.01.2017 | Awards Funding
20.01.2017 | Materials Sciences
20.01.2017 | Life Sciences