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Histologic grade, stage, and survival in breast carcinoma†‡

Comparison of African American and Caucasian women

  1. Donald Earl Henson M.D.1,§,*,
  2. Kenneth C. Chu Ph.D.2,
  3. Paul H. Levine M.D.3

Article first published online: 1 JUL 2003

DOI: 10.1002/cncr.11558

Issue

Cancer

Cancer

Volume 98, Issue 5, pages 908–917, 1 September 2003

Additional Information

How to Cite

Earl Henson, D., Chu, K. C. and Levine, P. H. (2003), Histologic grade, stage, and survival in breast carcinoma. Cancer, 98: 908–917. doi: 10.1002/cncr.11558

Author Information

  1. 1

    Department of Pathology, Office of Cancer Prevention and Control, The George Washington University Cancer Institute, Washington, DC

  2. 2

    Center to Reduce Cancer Health Disparities, National Cancer Institute, Bethesda, Maryland

  3. 3

    Department of Epidemiology and Biostatistics, The George Washington University School of Public Health and Health Services, Washington, DC

  1. §

    Fax: (202) 994-2618

*Department of Pathology, The George Washington University Medical Center, Ross Hall, Room 502, 2300 I Street, NW, Washington DC, 20037

  1. †

    The opinions expressed herein do not necessarily reflect the views of the National Cancer Institute or the U. S. Government.

  2. ‡

    This article is a US Government work and, as such, is in the public domain in the United States of America.

Publication History

  1. Issue published online: 20 AUG 2003
  2. Article first published online: 1 JUL 2003
  3. Manuscript Accepted: 7 MAY 2003
  4. Manuscript Revised: 1 MAY 2003
  5. Manuscript Received: 13 MAR 2003

Funded by

  • Komen Foundation

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Keywords:

  • breast carcinoma;
  • race;
  • survival;
  • histologic grade;
  • stage;
  • tumor size;
  • African American women;
  • Caucasian women

Abstract

BACKGROUND

African American women have lower breast carcinoma survival rates than do Caucasian women. African American women often present with advanced-stage disease and more aggressive tumors as shown by histologic and laboratory-based prognostic factors. Aggressive tumor behavior may be responsible, at least in part, for the advanced stage and reduced survival rates.

METHODS

The authors investigated the correlation between survival and histologic grade, stage of disease, and tumor size for both African American and Caucasian women who were younger than age 50 years and age 50 years and older. The authors also investigated the distribution of grade within each stage group and the distribution of grade by tumor size. African American and Caucasian women were matched by stage, tumor size, and histologic grade. Survival was represented by 6-year breast carcinoma–specific survival rates.

RESULTS

Compared with Caucasian women, African American women, regardless of age, had proportionally more Grade III tumors and fewer Grade I and II tumors for all stages combined and for each individual stage group. Similarly, matched for tumor size, African American women had more Grade III tumors and fewer Grade I and II tumors compared with Caucasian women, except for tumors smaller than 1.0 cm. For nearly all combinations of stage and grade regardless of age, the 6-year breast carcinoma–specific survival rate was lower for African American women than for Caucasian women, although it did not always reach statistical significance.

CONCLUSIONS

Compared with Caucasian women, African American women, regardless of age, presented with proportionally more aggressive tumors for each stage of disease and for each tumor size above 1.0 cm as revealed by the histologic grade. Higher histologic grade may be a significant contributing factor to survival disadvantage for African American women. Cancer 2003;98:908–17. Published 2003 by the American Cancer Society.

DOI 10.1002/cncr.11558

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