Diversity in Breast Cancer- Genomics to Racial Disparities - DVD

Guests:

• Lyndsay Harris, M.D., Director
• Shon Black, M.D., Surgeon
• Anna Martin, MSW, Coordinator, Yale Breast Cancer Disparities Program

1. Molecular Profiling in Breast Cancer

a) Microarray Profiling:
- Explains behavior of some genes
- Sheds light on mechanisms of resistance
- Helps to better understand how gene expression patterns vary, and
- How gene expression influence patient outcomes

b) Molecular Classifications Are Important Because They:
- Reduce heterogeneity/differences of patient groups
- Increase likelihood of response to therapy
- Make class distinction between Estrogen Receptor (ER) Positive and/or Progesterone Receptor (PR) Negative tumors
- ER Positive tumors respond to anti-estrogenic therapy
- ER Negative tumors do not respond to such therapy

c) Expression Profiling Identifies Subgroups Across Platforms

2. “Triple Negative Breast Cancers – A Bad Actor with Unique Biologic Features”
“Expressed as: ER/PR/HER2” – Represents an aggressive and poorly understood subclass of Breast Cancer with a much worse outcome. (Journal of Clinical Pathology 2006)

- Affect African-American women more than Caucasian women
- Affect AA women at a younger age
- Higher mortality rate for AA women than Caucasians

3. Differences in Breast Cancer by Race:

- Triple Negative tumors occur more frequently in pre-menopausal African-American women
- African-American women under age 50 have 39% frequency of these cancers
- Caucasian women of same age have 16% Triple Negative Cancers
- AA women with Breast Cancer have 37% higher death rate
- AA women under age 35 have higher incidence of Breast Cancer
- AA women with TNC have worse prognosis with metastases (spread)

4. Differences May Be Accounted for Due to:

- Limitations to access and screening programs
- More aggressive tumor biology
- Increased tumor genetic alterations
- Inadequate oncologic treatment

5. The Good News:

- Clinicians at Yale (including Dr. Harris) & Office for Elimination of Cancer
Disparities are studying to prevent:
a) The worse outcomes for African-American women
b) The contributions of genetic alterations in young AA women with /basal-like breast cancers
c) They will evaluate diagnostic imaging modality most frequently use, and which is most effective
d) Will examine genetic alterations in minority & non-minority patients
e) Implement prevention programs to increase local community involvement in breast cancer awareness
f) Improvement in follow-up system of abnormal mammograms & identify high risk women early
g) Goal to reduce negative outcomes for target populations

Contact Information for Yale:
Yale Cancer Center – 866 – Yale Cancer
Web site: www.yalecancercenter.org

Breast Imaging & Mammogram Mobile Van (203) 688 – 6800
Medical Oncology (203) 785-4191
Genetic Counseling (203) 764- 8400
Patient Care Coordinator (203) 785-2328
American Cancer Society
1·800·ACS·2345 -www.cancer.org

www.breastcanceralliance.org