Can genetics explain triple negative breast cancer?
My story yesterday on the racial disparity in breast cancer deaths highlighted the debate over whether biology or environment is the cause of the problem. A recent study suggests that access to care alone can't explain the disparity, reopening a long-brewing discussion about whether genetics is the reason black women are more likely to die of the disease than white women.
Using genetics to explain racial disparities in health is a touchy topic. When I spoke to Dr. Otis Brawley at the American Cancer Society, he said he worried that the issue hearkens back to the old argument about blacks and genetic inferiority.
Yet, others insist genetic research is key to unlocking the mysteries of racial disparities and, most importantly, finding a cure. There's a great piece in CNN's Black in America 2 series, about Dr. Lisa Newman, an African-American female surgeon, who travels to Ghana searching for genetic clues to why black women are twice as likely to get a rare and aggressive form of breast cancer known as triple negative.
Newman found that some 60 percent of Ghanaian women who have breast cancer have the triple negative type. Women with this type lack the three hormone receptors that are the target of the most effective drug treatments we have now and must rely on standard chemotherapy, which often isn't as effective.
The CNN piece is as much about Newman's journey as it is about the science behind her discoveries:
Newman gathers samples at a local Detroit, Michigan, hospital and at events held by the Sisters Network, an organization for black breast cancer survivors. She runs DNA comparisons to the samples gathered in Ghana and one day hopes to correlate African ancestry with the risk of being diagnosed with triple negative breast cancer in African-Americans. If this happens, according to Newman, it will open doors to new treatments.
photo courtesy of CNN









Comments
Ok, this is wonderful, great, etc. But I am white and was just diagnosed 2/23/09, at age 62 with this beast of a disease. So much for young, premenopausal black women suffering from this disease. I am to and I don't fit any of the cited criteria.
Posted by: LRM216 | July 28, 2009 2:20 PM
Why, in an age of such genetic enlightenment and advanced research, we are still using racial labels and non-medical terms such as black and white to describe medical diagnoses instead of using a detailed description of family history and ancestry, is beyond belief.
Geneticists have already indicated that Africans are more diverse in ancestry among each other than other groups, because humans have been settled in Africa for tens of thousands of years. There are many groups blended into each of our modern ethnic group, whether it's in Africa or elsewhere, but many more in Africa.
There are 60 ethnic groups in Ghana, for example, and each has a diverse and interblended ancestry. That's where medical research needs to focus on ancestral history, especially when researching the genes that were inherited from our ancestors, our predisposition to health or diseases, and our medical diagnoses. That's what genetics call, epigenetics -- the inherited, biological and environmental space in which our genes survive.
When I traced my ancestors to Ghana, I researched the variety of medieval and ancient ancestors blended into our DNA. I did the same for the ancestors I found in Europe in the British Isles in Scotland and England. With such a variety of genes and history blended from tens of thousands of years, we need to do much more careful and informed medical research and diagnoses.
I wrote an article about this topic recently.
http://www.scienceblog.com/cms/blog/7846-personalized-genomic-medicine-are-we-and-our-doctors-ready-23012.html
Pearl Duncan
Posted by: Pearl Duncan | July 29, 2009 8:14 AM
In this day and age, when causes for certain disease or illness can't be found, it is easier to cast blame on the victim by saying it is because they are "black and don't have access to health care or they don't go to the doctor'. This wasn't the case for my sister Islande who was diagnosed with triple negative breast cancer at the age of 35. She went to the doctor every year. She was in great health and excellent shape.
Two weeks before she was diagnosed with stage four of this deadly disease which took her life 15 months later, she had a negative mammogram. She went to her doctor because of a lump under her arm which turned out to be a malignant carcinoma while her mammogram was negative. What are we to do when the experts don't know how to treat us?
I hope someone finds a treatment for this deadly beast soon so other families don't go through what our family is going through by losing my precious sister on July 3rd to this deadly beast.
Love you and miss you sis. Michelle
Posted by: Michelle Oriol-Cameau | July 29, 2009 9:51 PM
I am an African American woman who was diagnosed with triple negative breast cancer in 2007. It has been a hard road but I am still here! What disturbs me about this article is why Otis Brawley talks about the genetic inferiority of blacks? I never felt genetically inferior and nobody never talked about me like that. People who talk like belong to the KKK. Otis Brawley must have low self-esteem to act like such a race hustler.
Posted by: Delores Lacrima | July 30, 2009 4:41 AM
Thank you ladies for sharing your personal stories. What strength you have to endure such an ordeal. I wish you all the best. Take care.
Posted by: Kelly | August 3, 2009 10:37 AM
I am a middle-aged Caucasian woman who has Triple Negative Breast Cancer and am currently undergoing chemo. I am disappointed that this article does not the discuss the possibility of the genetic mutation BRCA 1/2 gene. Several TNBCers have that genetic mutation, which does exist in Caucasian women of all ethnic backgrounds, as well as in African American women and women of Askenaski (please forgive my mispelling) Jewish descent. And I will tell you that many Caucasian women have this type of breast cancer aka "the beast". Please, let us not be making decisions based on racial lines. It's good to understand that TNBC seems to affect a larger number of AA women, but we need to understand WHY that is...at least here in the states. We are sending out a the WRONG message here.
I am of Sicilian heritage; Sicily was settled by many tribes of all ethnic/racial/cultural backgrounds over thousands of years. Since no one else in my white family has Breast Cancer of any form, could I be the genetic freak? It's entirely possible. This is why Ms.Sibelieus needs to sign into law mandatory insurance payment for BRCA 1/2 testing.
And Ms. Duncan, I also had a negative mammogram less than five months before I found my small but extremely agressive cancerous lump during a self-exam in the shower (an ultra sound revealed a second rapidly growing one as well). My sympathies to you and your family on your loss.
Posted by: Honey | August 6, 2009 8:43 AM
For further information and to read of real women being affected by this horrific disease, please visit:
http://www.tnbcfoundation.org/index.html
Posted by: Honey | August 6, 2009 8:50 AM
I don't know why this article would bother any one. The doctor does NOT say that black people are inferior. This was an old, long ago belief and he worries that this may rekindle that thought. But that is no reason to not look at this link. They can't find a cure with out finding the cause. Looking at a large concentraited group of people with triple negative breast cancer is the best way to find the cause. If the people reading these would stop looking for reasons to defind one group over another and think about ending this "beast" we would all be better off. I am a white woman that was diagnosed with this 2 1/2 years ago and still hoping that it won't come back in me like it did in my sister who it has already killed. I could look at this and many other articles and ask why are the black women getting all the attention and research, it's not fair, but I don't. I know that while focusing on black women with triple negative breast cancer, this reasearch will benefit all women with this type of cancer.
Posted by: Diane | September 26, 2009 10:54 PM