Ijaduola T G, Smith E B
Department of Head and Neck Oncology, University of Ibadan, Nigeria.
J Natl Med Assoc. 1998 Sep;90(9):547-51.
This study reviews the current understanding of the pattern of breast cancer among whites, African Americans, and West Africans who have never immigrated to the US to find better ways of improving the prevention, early detection, and care of breast cancer world-wide. In the United States, the behavior pattern of breast cancer in African-American women differs from that of white women. Among the three populations, breast cancer appears to be least common in nonimmigrant West-African women. The peak incidence in African Americans and West Africans occurs around the premenopausal period while it occurs postmenopausal period in whites. Also, unlike white women, West-African and African-American women present late for treatment with a greater cancer burden and consequently lower survival rates. The predominant histological type is infiltrating ductal carcinoma in the three groups but the highest percentage (33%) of infiltrating poorly differentiated anaplastic carcinoma occurs in West Africans. Menstrual and obstetric history, obesity, and high body mass index status appear to be greater specific risk factors among African Americans than among West Africans. African Americans and West Africans have three "Ls" in common: late stage in seeking treatment, lower age at peak incidence with severe tumor burden, and consequently lower survival rates. There is a need for more detailed population-based research at molecular levels to elucidate the basis for some of these features.
本研究回顾了目前对从未移民到美国的白人、非裔美国人和西非人中乳腺癌模式的理解，以寻找改善全球乳腺癌预防、早期检测和护理的更好方法。在美国，非裔美国女性乳腺癌的行为模式与白人女性不同。在这三个人群中，乳腺癌在未移民的西非女性中似乎最不常见。非裔美国人和西非人的发病高峰出现在绝经前期，而白人则出现在绝经后期。此外，与白人女性不同，西非和非裔美国女性就诊时病情较晚，癌症负担较重，因此生存率较低。三组中主要的组织学类型是浸润性导管癌，但浸润性低分化间变性癌比例最高（33%）的是西非人群。月经和产科病史、肥胖以及高体重指数状况在非裔美国人中似乎比在西非人中更是特定的风险因素。非裔美国人和西非人有三个共同特点：治疗就诊晚、发病高峰年龄较低且肿瘤负担严重，因此生存率较低。需要在分子水平上开展更详细的基于人群的研究，以阐明其中一些特征的基础。
