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Cancer Resources > Cancer News > 2009 > May

Earlier breast cancer screening for black women may be warranted

Martha Kerr

Last Updated: 2009-05-13 11:45:52 -0400 (Reuters Health)

NEW YORK (Reuters Health) - If current breast cancer screening recommendations are followed for African American women, more than 10% will already have advanced disease at first detection, a study published in the May issue of the Journal of the American College of Surgeons indicates.

"We believe that African American women may consider earlier breast cancer screening, possibly starting around 33-35 years of age," Dr. Leonidas G Koniaris advised during an interview with Reuters Health. "It is at this age that the incidence of breast cancer in African American patients equals that for Caucasian women at 40 years of age, the suggested age to start screening."

Dr. Koniaris of the University of Miami and colleagues identified 63,472 breast cancer patients between 1998 and 2002 on analysis of a Florida cancer registry and inpatient hospital data. Of these, 90.5% were Caucasian and 7.6% were African-American.

African American patients presented at a younger age and with more advanced disease on first diagnosis. The researchers found that 10.5% presented with breast cancer before the age of 40 years, and 22.4% before age 45 years. African American patients were also less likely to receive surgery.

"Based upon our study, African American women have a 1.72-fold increased risk of death from breast cancer," Dr. Koniaris told Reuters Health. "Approximately two-thirds of this excess risk is attributable to late stage presentation."

Low socioeconomic status was also an independent predictor of worse prognosis after controlling for co-morbidities and treatment. Women of low socioeconomic status presented with larger tumors on initial diagnosis and were less likely to receive surgery.

"The issue of how best to initiate earlier screening will likely be the topic of future studies," Dr. Koniaris said. "Based upon the current literature, we would suggest screening mammography with additional ultrasound. Consideration of MRI would also have to be examined."

J Am Coll Surg 2009;208:853-870.

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