Breast cancer racial differences before age 40--implications for screening.

Area of Science:

• Oncology
• Public Health
• Radiology

Background:

• Current breast cancer screening guidelines generally recommend mammograms starting at age 40.
• Studies indicate mammography reduces mortality in the 40-49 age group for the general population.
• African-American women are diagnosed with breast cancer more frequently before age 40 and often present with advanced disease.

Purpose of the Study:

• To investigate if African-American women aged 30-39 benefit from earlier mammogram screening due to increased vulnerability.
• To compare the age-specific distribution and incidence of breast cancer in African-American and white women.
• To analyze prognostic indicators in young African-American and white breast cancer patients.

Main Methods:

• Comparison of age-specific breast cancer patient distribution (ages 30-84) in five state cancer registries.
• Analysis of prognostic indicators (tumor size, nodal status) for cases under 40 in two registries.
• Evaluation of age-specific incidence (ages 30-39) using SEER data (1994-1998) and U.S. Census 2000 data.

Main Results:

• Significant differences found in age-specific distribution and incidence between African-American and white breast cancer patients.
• Over 10% of African-American women were diagnosed before age 40, compared to 5% of white patients.
• Younger African-American women showed more advanced disease indicators (larger tumor size, higher nodal status) at diagnosis.

Conclusions:

• African-American women aged 30-39 exhibit a higher incidence and more aggressive disease presentation, indicating a high-risk group.
• Evidence suggests this demographic may benefit from earlier breast cancer detection efforts.
• Despite challenges with mammography in younger women, the elevated mortality and incidence gap support considering early screening mammography.