Breast cancer in sub-Saharan Africa: How does it relate to breast cancer in African-American women?
Version of Record online: 14 MAR 2005
Copyright © 2005 American Cancer Society
Volume 103, Issue 8, pages 1540–1550, 15 April 2005
How to Cite
Fregene, A. and Newman, L. A. (2005), Breast cancer in sub-Saharan Africa: How does it relate to breast cancer in African-American women?. Cancer, 103: 1540–1550. doi: 10.1002/cncr.20978
- Issue online: 4 APR 2005
- Version of Record online: 14 MAR 2005
- Manuscript Accepted: 20 DEC 2004
- Manuscript Revised: 2 NOV 2004
- Manuscript Received: 8 SEP 2004
- breast cancer;
- African-American women;
- African women;
- hereditary breast cancer
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. Cancer 2005. © 2005 American Cancer Society.