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Open Access Highly Accessed Research article

Breast cancer histology and receptor status characterization in Asian Indian and Pakistani women in the U.S. - a SEER analysis

Madhuri Kakarala12*, Laura Rozek3, Michele Cote3, Samadhi Liyanage1 and Dean E Brenner124

Author Affiliations

1 Division of Hematology/Oncolog, Department of Internal Medicine, University of Michigan, 2150 Cancer Center, 1500 E Medical Center Drive, Ann Arbor, MI 48109-5390, USA

2 V.A. Medical Center, 2150 Cancer Center, 1500 E. Medical Center Dr., Ann Arbor, MI 48109-5390, USA

3 School of Public Health, Environmental Health Sciences, 6630 SPH 1, Ann Arbor, MI 48109-2029, USA

4 Department of Pharmacology, University of Michigan, 2150 Cancer Center, 1500 E Medical Center Drive, Ann Arbor, MI 48109-5390, USA

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BMC Cancer 2010, 10:191  doi:10.1186/1471-2407-10-191

Published: 11 May 2010

Abstract

Background

Recent reports suggest increase in estrogen receptor (ER), progesterone receptor (PR) negative breast cancer yet little is known about histology or receptor status of breast cancer in Indian/Pakistani women.in the U.S.

Methods

We examined the United States National Cancer Institute's Surveillance Epidemiology and End Results (SEER) Cancer program to assess: a) frequency of breast cancer by age, b) histologic subtypes, c) receptor status of breast cancer and, d) survival in Indians/Pakistanis compared to Caucasians. There were 360,933 breast cancer cases diagnosed 1988-2006. Chi-Square analyses and Cox proportional hazards models, to estimate relative risks for breast cancer mortality after adjusting for confounders, were performed using Statistical Analysis Software 9.2.

Results

Among Asian Indian/Pakistani breast cancer patients, 16.2% were < 40 yrs. old compared to 6.23% in Caucasians (p < 0.0001). Asian Indian women had more invasive ductal carcinoma (69.1 vs. 65.7%, p < 0.0001), inflammatory cancer (1.4% vs. 0.8, p < 0.0001) and less invasive lobular carcinoma (4.2% vs. 8.1%, p < 0.0001) than Caucasians. Asian Indian/Pakistani women had more ER/PR negative breast cancer (30.6% vs. 21.8%, p = 0.0095) than Caucasians. Adjusting for stage at diagnosis, age, tumor grade, nodal status, and histology, Asian Indian/Pakistani women's survival was similar to Caucasians, while African Americans' was worse.

Conclusions

Asian Indian/Pakistani women have higher frequency of breast cancer (particularly in age < 40), ER/PR negative invasive ductal and inflammatory cancer than Caucasians.