A higher incidence of secondary breast cancer is seen among Black women regardless of age, research has found.
The findings were highlighted during a press call from the fourth American Association for Cancer Research conference on The Science of Cancer Health Disparities held September 18–21 in Washington, D.C.
The teleconference was hosted by Chanita Hughes-Halbert, director of the Center for Community-Based Research and Health Disparities at the University of Pennsylvania.
When cancer is diagnosed in women younger than 45 years old, the incidence of primary breast cancer is higher among Blacks than among whites — and the cancer tends to be more aggressive.
“While the incidence of breast cancer is generally higher among whites for first-time diagnosis, we found the incidence of the second contralateral diagnosis was higher among Blacks,” said lead researcher Nsouli Maktabi Hala, Ph.D, graduate of George Washington University.
“Our findings were unexpected, since Blacks have a higher mortality rate than whites from the first cancer, so you would expect Blacks to have lower rates of second cancers.”
The research also found that when cancer is diagnosed at an older age, the incidence is higher among white women. Since most breast cancers are diagnosed in older women, the overall incidence is higher in whites, said Maktabi.
Maktabi said about four percent of all breast cancer patients will present with a second primary cancer.
“Collectively our findings should urge physicians to watch patients carefully for the second breast cancer in the contralateral breast, especially in the first six to 10 years following the diagnosis of the first time,” Maktabi said.
The researchers used the Surveillance Epidemiology and End Results Registry 9 data to determine breast cancer incidence among 415,664 white women and 39,887 Black women diagnosed with primary breast cancer at age 19 or older and possible development of a second cancer in the opposite breast.
Results showed that 22,290 (40 percent) developed a second breast cancer, of which 18,142 (four percent) occurred in the opposite breast. Incidence of second primary cancers of the opposite breast was higher among Black women and 15,101 (83.2 percent of second cancers developed in those who were diagnosed with first breast cancer at age 45 or older.
Maktabi joined three other researchers in highlighting their studies during the teleconference.
According to study results, an association has been found between stress and breast cancer aggressiveness.
“We found that after diagnosis, Black and Hispanic breast cancer patients reported higher levels of stress than whites and that stress associated with tumor aggressiveness, said Garth H. Rauscher, Ph.D., associate professor of epidemiology in the division of epidemiology and biostatistics at the School of Public Health, University of Illinois at Chicago.
Rauscher and colleagues studied patient perceptions of fear, anxiety and isolation, together referred to as psychological stress and associations with breast cancer aggressiveness.
The study included 989 breast cancer patients who were recently diagnosed. Of those, 411 were non-Hispanic Black, 937 were non-Hispanic white, and 181 were Hispanic. Results showed that psychosocial stress scores were higher for both Black and Hispanic patients compared to white patients.
“Those who reported higher levels of stress tended to have more aggressive tumors. However, what we don’t know is if we had asked them the same question a year or five years before diagnosis, would we have seen the same association between stress and breast cancer aggressiveness?” Rauscher said in a release.
Depression affected preventive health screenings among Latina breast cancer survivors according to data presented during the conference.
“Depression can make people more inattentive to potential risks to their health and more likely to ignore recommendations to reduce their risk,” said lead researcher Amelie G. Ramirez, professor and director of the Institute for Health Promotion Research at the Cancer Therapy and Research Center at the University of Texas Health Science Center at San Antonio.
Ramirez and colleagues examined the extent of depression among a group of 117 Latina breast cancer survivors to assess the barriers to preventive health screenings for colorectal and ovarian cancer.
“The most important thing we found was that Hispanic breast cancer survivors were more depressed than Hispanics in the general population and that they were not following recommendations to continue other cancer screening behaviors.”
Research also indicated that U.S. immigrants are still less likely to have undergone breast cancer screenings than native U.S. women.
Researchers at Pennsylvania State University believe that lack of access to health insurance and a regular source of health care are important factors related to the lower percentage of mammography screening among U.S. immigrants.
“There is progress, overall, in use of mammography among foreign-born women in the United States, but there is still a lot of work to do to improve their use of recommended breast cancer screening,” said lead researcher Nengliang Yao, a doctoral student in health policy and administration.