Study To Investigate Causes Of Breast Cancer In Blacks

CHAPEL HILL, N.C. - UNC scientist Robert Millikan will partner with Christine Ambrosone, of Roswell Park Cancer Institute, and Julie R. Palmer, of Boston University, in the most ambitious study to date of breast cancer among younger Black women.

Data from UNC Lineberger Comprehensive Cancer Center’s Carolina Breast Cancer Study demonstrated that Black women under the age of 45 are more likely to be diagnosed with aggressive types of breast cancer than are women of European ancestry. The current five-year research project has been awarded $19.3 million in funding from the National Cancer Institute to try to understand this important health disparity.

Millikan, PhD, DVM, Barbara Sorenson Hulka Distinguished Professor of Epidemiology in the UNC Gillings School of Global Public Health and a member of UNC Lineberger Comprehensive Cancer Center, has directed the Carolina Breast Cancer Study for over a decade.

He explains, “This project will collect data on more than 5,000 African-American women and as such will be the largest study of its type. Our aim is to explore the potential biologic, environmental and epidemiologic causes of this difference in cancer incidence. Our previous studies and those of our colleagues have suggested hypotheses that we will be investigating with this larger group of patients.”

The grant will bring together breast cancer cases from four on-going studies – the Carolina Breast Cancer Study (CBCS), Women’s Circle of Health Study (WCHS), Black Women’s Health Study (BWHS), and Multiethnic Cohort Study (MCS)- and over 5,000 controls, or healthy, women.

Shelley Earp, MD, director of UNC Lineberger, explained, “During the last decade UNC researchers, including Charles Perou, Lisa Carey and Robert Millikan, have demonstrated that breast cancer is not one disease, but consists of at least five different subtypes.

Their work initiated the exploration of black/white differences in breast cancer subtypes. The current study will assemble a population of African-American patients large enough to thoroughly examine the range of risk factors and genes that could be associated with the different breast cancer subtypes.”

With Millikan, the research is being led by Christine Ambrose, PhD, professor of oncology and chair of the department of cancer prevention and control, division of cancer prevention and populations science, at Roswell Park Cancer Institute, and Julie R. Palmer, ScD, professor of epidemiology at the Slone Epidemiology Center at Boston University.

In a united effort, the investigators will focus on subtypes of breast cancer, especially aggressive ones, and provide critical answers to improving treatment and reducing the risk of breast cancer among young Black women.

Specific issues that will be addressed with this multi-faceted approach will include genetic susceptibility; reproductive history, lactation, and hormonal factors; body size, early life and adult physical activity, and gene/environment interactions; and other risk factors in relation to breast cancer subtypes.

Black women under age 45 have a 76 percent 5-year relative survival rate compared to young white women who have an 88 percent survival rate (for the years 2001-2007, the most recent years for which data are available).

The Carolina Breast Cancer Study Phases I and II enrolled over 2300 women with breast cancer and 2000 controls between 1993-2001. Phase III of CBCS will be part of the funded study and will additionally look at the outcomes of breast cancer therapy in North Carolina women, both Black and Caucasian.