Research could help fight breast cancer
LORNA MARSH Women who get breast cancer early could be given a better chance of fighting it thanks to research by a Norwich scientist, who has looked at mortality rate between different skin colours.
Women who get breast cancer early could be given a better chance of fighting it thanks to research by a Norwich scientist.
Isaac Gukas, of the UEA, looked at the fact that black women with breast cancer have a higher mortality rate than their white counterparts coupled with evidence showing they also contract the cancer on average much younger.
Dr Gukas, who is based at the university's School of Medicine, Health Policy and Practice, has now put forward the theory that it is because surgery to remove the tumour in pre-menopausal women can actually encourage more growth.
The hypothesis could have far-reaching effects on the treatment of women of all races who contract the cancer before the menopause.
If confirmed it would give clinicians a better insight into the implications of surgery to remove breast tumours from pre-menopausal women which might then enable them to revise procedures to help stem further growth.
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The research paper, jointly written by Dr Gukas, Dr Michael Retsky, of t the Children's Hospital, Boston, Romano Demicheli, of the Istituto Nazionale Tumori, Milan, and William Hrushesky of the University of South Carolina, was published in the International Journal of Surgery.
A previous study by Dr Gukas identified a mean age of 43 for diagnosis of breast cancer in Nigerian women compared with a mean age of 64 in the United Kingdom. More than 70pc of the Nigerian cases were aged below 50, compared to less than 20pc of cases in the UK.
Further research published in 2005 suggested that those who underwent surgery for the disease before the menopause were more likely to relapse.
Dr Gukas said: “Surgery to remove a primary tumour induces the formation of new blood vessels known as angiogenesis. In pre-menopausal women who have high levels of oestrogen and other hormones, this may encourage the growth of the tumour.”
Dr Gukas's experience as a clinician treating breast cancer in Africa led him to form the hypothesis that surgery-induced angiogenesis might explain the very high early mortality and generally poor outcome of patients in that part of the world.
“We do not have enough evidence to alter treatment at present and younger women should not be deterred from having surgery. But, if further studies confirm our hypothesis, we may need to give them appropriate chemotherapy, including angiogenesis inhibitors, beforehand to ensure the best outcome,” he said.
“We do not intend to oversimplify this subject, but it seems clear that at least part of the phenomenon of widening mortality along racial lines could be attributed to surgery leading to accelerated tumour growth in pre-menopausal women… now we need further research to confirm these observations before we explore any necessary changes in practice.”
A racial disparity in mortality rates from breast cancer in the US first appeared in the 1970s coinciding with the introduction of mammography.
The average age of breast cancer diagnosis in African American women is 46, compared with 57 for European Americans, although no one has yet identified why black women get the disease earlier.