Breast masses in African American teenage girls.

PURPOSE: The aim of this study was to evaluate the incidence of malignancy in breast lumps excised from African American teenagers. METHODS: The authors reviewed the pathology records at King's County Hospital Center between January 1982 and December 1992. The pathology reports and charts of all patients who had breast masses excised during this period were reviewed. Data for this study were derived from the group of African American and black Caribbean American teenage patients who underwent breast biopsies and whose pathology reports and medical records were available. The age of patients, size of the lesion, and diagnosis were recorded. RESULTS: Medical records from 155 African American and black Caribbean American girls between the ages of 13 and 19 years (inclusive) who underwent breast biopsies between January 1982 and December 1992 were reviewed. Fibroadenoma was the most common diagnosis (127 of 155; 82%). This was followed in frequency by fibrocystic mastopathy (18 of 155; 11.6%) and breast abscess (3 of 155; 2%). None of the patients had a malignancy. Review of tumor registry data from the same time period at Kings County Hospital Center and the University Hospital of Brooklyn showed that the youngest African American or black Caribbean American patient diagnosed with breast cancer was 21 years of age. CONCLUSIONS: The incidence of malignant breast lumps in African American and black Caribbean American teenagers is distinctly low. Conservative treatment in this population is warranted, and diagnosis can be made easily in most cases with either needle aspiration for cytology or core biopsy of any lesions discovered.

Is race a poor prognostic factor in breast cancer?

BACKGROUND: African American breast cancer patients have a higher mortality rate than their Caucasian counterparts. The purpose of this study was to evaluate whether race is a poor prognostic factor in breast cancer survival after multiple other prognostic factors are taken into account. STUDY DESIGN: The tumor registry data from two institutions between the years 1982 and 1995 were combined for the analysis. A total of 1,745 patients, including 1,297 African American and 448 Caucasian women, were available for analysis. Race, age, income, stage, histologic findings, type of operation, and treating institution were evaluated as possible key prognostic variables. RESULTS: In a univariate Cox proportional hazards regression analysis, African American patients with breast cancer were 1.27 times more likely to die than Caucasians when death from disease was measured (p = 0.01, 95% confidence interval 1.03 to 1.47). When all factors were included in a Cox regression analysis, only the stage of disease at diagnosis, age, and whether the patient had a therapeutic surgical treatment were statistically significant. Race, income, hospital, and histologic findings were not significant, although they were significant when used in a univariate analysis. CONCLUSIONS: Poor survival of African American breast cancer patients seems to be related to their advanced stage at presentation and young age. To improve survival in these women, efforts should be concentrated on aggressive screening at a young age to detect the disease at an earlier stage.

Age at presentation of African-American and Caucasian breast cancer patients.

BACKGROUND: The purpose of this study was to compare the age at presentation of Black-American (Caribbean-American and African-American) and Caucasian breast cancer patients. STUDY DESIGN: We reviewed the records of all breast cancer patients seen at King's County Hospital Center and SUNY Health Science Center at Brooklyn between 1982 and 1995. The patients were stratified based on ethnicity. Age distribution, median, and mean ages are compared for Black-American and Caucasian patients. RESULTS: The median age, mean age, and standard deviation for 1,632 African-American patients was 54, 54.17, and 13.11 years, respectively, whereas for 671 Caucasians patients it was 62, 60.35, and 13.85 years, respectively. Using the Student's t-test for equality of means there is a statistically significant difference in the mean age of presentation for the 2 ethnic groups with a p < 0.001 and a 95% confidence interval for difference (4.960, 7.405). More than one-third (37.7%) of Black-American breast cancer patients present younger than 50 years of age compared with 24.7% for Caucasians. CONCLUSIONS: The younger age at presentation of Black-American breast cancer patients ought to be considered while setting screening guidelines for that group of women.