TRIPLE NEGATIVE BREAST CANCER TNBC ETHNIC MINORITIES What

TRIPLE NEGATIVE BREAST CANCER (TNBC) & ETHNIC MINORITIES

What is TNBC Each type of cancer is defined by the presence of certain hormone receptors � These are Oestrogen (ER), Progesterone (PR) and Human Epidermal Growth Factor Receptor (HER 2) � The term ‘’triple negative’’ is an immunohistochemical description arising from a triple negative staining for the ER, PR and HER 2 receptors � Class Receptor Status Luminal A ER+ and/or PR+, HER 2 - Luminal B ER+ and/or PR+, HER 2+ Triple Negative/Basal Like ER-, PR-, HER 2 - HER 2 ER-, PR-, HER 2+ Normal Breast Like Tumours Unclassified (expression similar to that of normal breast tissue and benign tumours)

Incidence and Prognosis TNBC accounts for 12 – 17% of breast cancer cases � Most frequently observed in younger non-Caucasion obese women � Has the worst outcome of all the subtypes � As a result, a TNBC diagnosis is described as a ‘’death sentence’’ by some patients �

Ethnicity and Triple Negative Breast Cancer Ethnicity and disease has been a focal point � Age and ethnicity have been identified as independent factors � TNBC has been widely researched in the past decade � Is it a coincidence that black women are most commonly diagnosed with the subtype that has the worst prognosis? �

Research Carol Parise et al, USA, 2010 study of 69, 358 women with primary invasive breast cancer � African-American women more likely to develop the triple negative subtype than Caucasian women and Asian women are more likely to develop the HER 2 subtype �

Research Helen Swede et al, USA, 2011 Carried out surveillance study � found that compared with white patients, black patients had nearly 3 times more prevalence of triple negative breast cancer, and almost double the rate of HER 2+. �

Research Ruth Jack et al, UK, 2013 used electronic pathology reports from 2005 – 2007 � patients under the age of 60, Black women were more likely to have TNBC than Caucasian women � South Asian women were also more like to have Triple Negative Breast cancer than Caucasian women � One of the rare UK research carried out �

Contributing factors? Different ethnic groups have different lifestyles, originate from different genomic groups and react differently to breast cancer screening, diagnosis and treatment � Established that lifestyle factors contribute to the likeliness of developing cancer such as; smoking and higher levels cholesterol. � With this in mind, and taking into account some of the ethnic groups in the UK, one can assume that for example; South Asians could be more likely to develop cancer alongside coronary heart disease due to high levels of cholesterol in their diets. �

Are Ethnic Minorities more likely to develop TNBC? � � � Complete study using UK data Lack of data A systemic review Extrapolate and relate studies from USA and Asia Pacific Small sub-study on recently collected data Carry out a complete study at some point here in the UK

Conclusion Definite link between ethnic minorities and TNBC � Expose and investigate the link here in the UK � May give rise to better screening and diagnosis methods � Better treatment and prognosis for TNBC patients �