Weiss S E, Tartter P I, Ahmed S, Brower S T, Brusco C, Bossolt K, Amberson J B, Bratton J
Mount Sinai Medical Center, Department of Surgery, New York, New York 10029, USA.
Cancer. 1995 Jul 15;76(2):268-74. doi: 10.1002/1097-0142(19950715)76:2<268::aid-cncr2820760217>3.0.co;2-1.
Poor survival among African American patients with breast cancer has been attributed to low socioeconomic status and lack of access to health care. However, Hispanics of equivalent socioeconomic status and health care access exhibit much higher survival rates, almost comparable to whites. This suggests that biologic differences play a role in differences in breast cancer survival in addition to socioeconomic and health care access factors.
The authors studied clinical and molecular differences between patients with breast cancer of different ethnicity to determine biologic explanations for the observed differences in survival. Consecutive patients scheduled for breast biopsies were identified preoperatively and were interviewed. Blood was withdrawn for serum marker measurements, and tumor specimens collected at frozen section diagnosis were analyzed by flow cytometry, hormone receptor concentration, tumor grade, and Ki-67 nuclear antigen, HER-2/neu, and epidermal growth factor oncoprotein expression.
Age, age at menarche, number of lymph nodes with metastasis, estrogen and progesterone receptor levels, ploidy status, S-phase, Ki-67, HER-2/neu expression, tumor grade, epidermal growth factor receptor expression, lipid-associated sialic acid (LASA), and carcinoembryonic antigen level were not significantly related to ethnicity. African Americans presented at a significantly more advanced stage and with significantly larger tumors. They were significantly heavier and had a significantly higher mean Quetelet's index and a significantly higher number of pregnancies and number of live births. Whites and Hispanics were significantly older at menopause.
The molecular indices associated with breast cancer prognosis do not differ significantly among whites, African Americans, and Hispanics, suggesting that the reported differences in survival among these groups are not due to biologic differences in breast cancer among ethnic groups.
非裔美国乳腺癌患者生存率低被认为与社会经济地位低和难以获得医疗保健有关。然而，社会经济地位和医疗保健机会相当的西班牙裔患者生存率要高得多，几乎与白人相当。这表明，除了社会经济和医疗保健机会因素外，生物学差异在乳腺癌生存差异中也起作用。
作者研究了不同种族乳腺癌患者的临床和分子差异，以确定观察到的生存差异的生物学解释。术前确定计划进行乳房活检的连续患者并进行访谈。采集血液用于血清标志物测量，并对冷冻切片诊断时收集的肿瘤标本进行流式细胞术、激素受体浓度、肿瘤分级以及Ki-67核抗原、HER-2/neu和表皮生长因子癌蛋白表达分析。
年龄、初潮年龄、转移淋巴结数量、雌激素和孕激素受体水平、倍体状态、S期、Ki-67、HER-2/neu表达、肿瘤分级、表皮生长因子受体表达、脂质相关唾液酸（LASA）和癌胚抗原水平与种族无显著相关性。非裔美国人就诊时病情进展明显更严重，肿瘤明显更大。他们明显更重，平均克托莱指数明显更高，怀孕次数和活产次数明显更多。白人和西班牙裔在绝经时年龄明显更大。
与乳腺癌预后相关的分子指标在白人、非裔美国人和西班牙裔之间无显著差异，这表明这些群体之间报告的生存差异并非由于不同种族乳腺癌的生物学差异所致。
