Fregene Alero, Newman Lisa A
Department of Surgery, University of Michigan Comprehensive Cancer Center, University of Michigan, Ann Arbor, Michigan 48109, USA.
Cancer. 2005 Apr 15;103(8):1540-50. doi: 10.1002/cncr.20978.
African-American women have had a lower incidence, yet higher mortality rate from breast cancer compared with White-American women. African-American women also have had a higher risk for early-onset, high-grade, node-positive, and hormone receptor-negative disease. Similar features have characterized hereditary breast cancer, prompting speculation that risk factors could be genetically transmitted. Further evaluation of this theory required the study of breast cancer among women from sub-Saharan Africa because of their shared ancestry with African-American women.
Publications from 1988 to 2004 of English-language literature on breast cancer in Africa were reviewed.
Women from sub-Saharan Africa were found to have a low incidence of breast cancer. This was partly explained by a largely protective reproductive history, including late menarche, early menopause, high parity with prolonged breastfeeding, irregular menses, and fewer ovulatory cycles. The average age at diagnosis, however, was approximately 10 years younger than breast cancer patients of western nations, and disease stage distribution was shifted toward more advanced disease, which resulted in higher mortality rates. These features were found to be similar to data on breast cancer in African-American women. Mutations in BRCA1 and BRCA2 have been reported in African-American women, but the extent of the contribution of BRCA1 and BRCA2 to breast cancer burden in Africa was uncertain. Limited financial resources lead to suboptimal cancer data collection, as well as delayed diagnosis and treatment of many African breast cancer patients.
Parallels between breast cancer burdens of African-American and sub-Saharan-African women were provocative, indicating the need for further exploration of possible genetically transmitted features related to estrogen metabolism and/or breast cancer risk.
与美国白人女性相比，非裔美国女性乳腺癌发病率较低，但死亡率较高。非裔美国女性患早发性、高级别、淋巴结阳性和激素受体阴性疾病的风险也更高。这些相似特征也是遗传性乳腺癌的特点，这引发了人们对于风险因素可能通过基因传递的猜测。由于撒哈拉以南非洲女性与非裔美国女性有共同的祖先，因此对这一理论进行进一步评估需要对她们中的乳腺癌情况展开研究。
回顾了1988年至2004年期间关于非洲乳腺癌的英文文献出版物。
发现撒哈拉以南非洲女性乳腺癌发病率较低。部分原因是她们有很大程度上具有保护性的生育史，包括初潮晚、绝经早、多产且母乳喂养时间长、月经不规律以及排卵周期较少。然而，其乳腺癌诊断的平均年龄比西方国家的乳腺癌患者小约10岁，且疾病阶段分布偏向于更晚期的疾病，这导致了更高的死亡率。这些特征与非裔美国女性乳腺癌的数据相似。有报道称非裔美国女性存在BRCA1和BRCA2基因突变，但BRCA1和BRCA2对非洲乳腺癌负担的贡献程度尚不确定。有限的财政资源导致癌症数据收集欠佳，以及许多非洲乳腺癌患者诊断和治疗延迟。
非裔美国女性和撒哈拉以南非洲女性乳腺癌负担之间的相似之处具有启发性，表明有必要进一步探索与雌激素代谢和/或乳腺癌风险相关的可能通过基因传递的特征。
