Mary G. McCrea Curnen

African-American/White differences in breast carcinoma: p53 alterations and other tumor characteristics.

Despite mounting evidence that breast tumors in African‐American (AA) women are more aggressive compared with breast tumors in white (W) women, little is known regarding racial/ethnic differences in genetic alterations that may be of prognostic importance.

Histologic types and hormone receptors in breast cancer in men: a population-based study in 282 United States men

Histologic slides from 282 incident cases of breast cancer in men, that were identified in 10 population-based cancer registries in the United States, were reviewed by a single pathologist. Breast cancer more often presented in the noninvasive stage in men (10.8 percent of all cases) than would be expected among women. All noninvasive carcinomas were of the ductal type. Of invasive carcinomas, compared with women, men had smaller proportions of lobular and mucinous types and larger proportions of ductal and papillary types and Pagets disease. No case of tubular or medullary carcinoma was seen. The breast in men is composed only of ducts and normally contains no lobules, and the histologic types of breast carcinomas that predominate in men are likely of ductal origin. Estrogen and progesterone receptors were present in 86.7 percent and 76.3 percent of invasive carcinomas, respectively, which are higher proportions than would be expected among women. Also, unlike findings in women, receptor content was not associated with patient age at diagnosis.

Explaining the Race Difference in Prostate Cancer Stage at Diagnosis

Prostate cancer is the most frequently diagnosed cancer in males in the United States, accounting for an estimated 186,320 new cases in 2008. There are striking racial or ethnic differences in prostate cancer incidence and mortality rates in the United States, with Black males 1.6 times more likely to be diagnosed and 2.4 times more likely to die with prostate cancer than Whites. Stage at diagnosis is a key prognostic factor for prostate cancer survival, with African-Americans generally diagnosed at a more advanced stage. To identify factors that explain the race-stage disparity in prostate cancer, we conducted a population-based case-case study of 251 African-American (46%) and White (54%) prostate cancer cases diagnosed in Connecticut between January 1987 and October 1990. Multivariate logistic regression was used to identify potential explanatory factors, including clinical, sociodemographic, medical care, insurance, digital rectal examination screening history, and lifestyle factors. Cox proportional hazards models assessed the impact of study variables on race differences in long-term survival. Modifiable factors such as screening practice and sociodemographic factors accounted for >60% of the race difference in prostate cancer stage at diagnosis. Histologic grade (Gleason score) accounted for comparatively less. Survival analyses confirmed the importance of tumor characteristics, education, and insurance in explaining observed race differences in survival. Although cases were identified before the widespread use of prostate-specific antigen (PSA) screening, the results should also be relevant to countries that have large underserved populations and/or disparities in access to medical care and cancer screening. (Cancer Epidemiol Biomarkers Prev 2008;17(10):2825–34)

Can mammography screening explain the race difference in stage at diagnosis of breast cancer

Background. A race difference in the stage at diagnosis of breast cancer is well established: African American women are less likely than white women to be diagnosed at a localized stage. The purpose of this study was to determine the extent to which the observed race (black/white) difference in stage at diagnosis of breast cancer could be accounted for by race differences in the mammography screening history.

Ionizing radiation and breast cancer in men (United States)

The purposes of this study were to determine whether exposure of the vestigial male breast to ionizing radiation is associated with an increase in risk of breast cancer and, if so, to determine whether the apparent effects on risk in men are similar to those reported for women. A population-based case-control study of breast cancer in men was conducted in 10 geographic areas of the United States. Information on possible prior exposure to ionizing radiation, and on other potential risk factors for breast cancer, was obtained from personal interviews of 227 cases and 300 controls who were recruited from October 1983 to September 1986. Evidence from this study that ionizing radiation can cause breast cancer in men includes: a modest trend of increasing risk with frequency of chest X-rays; an increase in risk in men with three or more radiographic examinations, especially if received prior to 1963; and an increase in risk in men who received X-ray treatments to the chest and adjacent body areas. Risk was increased only from 20 to 35 years after initial exposure from either radiographic examinations or X-ray treatments, and declined after three to four decades since last exposure, suggesting a wave of increased risk of finite duration following exposure. The doses of radiation received could not be estimated precisely, but those from diagnostic procedures were likely similar to those received by prepubertal females in prior studies, and the results of those and the present investigation are compatible. The carcinogenic effects of ionizing radiation may be similar in the male and prepubertal female breast.