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Special populations: Black women
Black women are more likely to develop aggressive breast cancers, and are more likely to die from their breast cancers. The reason for this is unclear. The National Cancer Institute has awarded a grant of approximately $12 million so that the biology of breast cancer in black breast cancer patients can be better understood. The results of this study will not be available to the public for several years, but the announcement brings much needed attention to this disparity. (8/15/16)
The National Cancer Institute (NCI), a part of the National Institutes of Health (NIH), is funding the “largest ever study of breast cancer genetics in black women,” saying that the “findings could inform breast cancer disparities.”
According to the NCI, non-melanoma skin cancers are the only cancers that occur more commonly in the U.S. than breast cancer, with at least 249,000 breast cancer cases expected in 2016. But for reasons researchers do not understand, the mortality rate among black women with breast cancer is about a 40% higher than their white counterparts, and black women are more likely than white women to develop more aggressive subtypes of breast cancer.
To understand breast cancer genetics, researchers have done genome-wide association studies (GWAS), which look to see which common gene changes are associated with a trait (in this case, breast cancer). However, the majority of these studies were done in patients of European and Asian descent. The studies found almost 100 gene variants that were associated with breast cancer in those patients, but while the association was found for European and Asian patients, the majority of those gene variants were not associated with breast cancer for black patients. It is important to note that GWAS studies look for small common changes in thousands of different genes. This differs from genetic testing for inherited cancer risk, such as BRCA testing or hereditary cancer panel testing, which looks at genes known to increase cancer risk.
This multimillion dollar NIH grant to better understand breast cancer genetics in black patients was awarded to Wei Zheng, from Vanderbilt University, Christopher Haiman, from the University of Southern California, and Julie Palmer, from Boston University.
The researchers will not be enrolling new patients specifically for this study, but will draw upon patients already participating in the African American Breast Cancer Consortium, the African American Breast Cancer Epidemiology and Risk (AMBER) Consortium, and the NCI Cohort Consortium. This study will include 20,000 black women with breast cancer. The genomes (all the genes in a person) of these 20,000 women will be compared to the genomes of 20,000 black women who do not have breast cancer and to the genomes of white women who do have breast cancer. From these comparisons, researchers will be able to identify genetic changes that are associated with breast cancer in black women, and see how these findings compare to white women with breast cancer.
According to a statement by Douglas Lowy, the acting director of the NCI, “This effort is about making sure that all Americans—no matter their background—reap the same benefits from the promising advances of precision medicine. The exciting new approaches to cancer prevention, diagnosis, and treatment ring hollow unless we can effectively narrow the gap of cancer disparities, and this new research initiative will help us do that…I’m hopeful about where this new research can take us, not only in addressing the unique breast cancer profiles of African-American women, but also in learning more about the origin of cancer disparities.”
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NIH Press Release: NIH launches largest-ever study of breast cancer genetics in black women
NIH Projects Reporter: Breast cancer genetic study in African-Ancestry populations
The New York Times
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Be Empowered Webinar: The “New” Genetic Testing: What You Need to Know
Joining FORCEs Newsletter: Combating Disparities: Research and Education on Hereditary Cancer in Black Women