Breast cancer in African American (AA) women tends to develop at an earlier age than in European American (EA) women and is more likely to have aggressive features characterized by high-grade, ER negative tumors and basal-like markers, which are associated with poorer prognosis. To address these issues, we are currently conducting a case-control study, the Women's Circle of Health Study, with two recruiting sites, one in NYC and another in NJ. AA and EA women newly diagnosed with invasive breast cancer or carcinoma in situ are identified through all major hospitals with large referral patterns for AA in Manhattan, Bronx, Brooklyn, and Queens (for the NYC site) and at all major hospitals in seven counties in northern NJ through rapid case ascertainment by NJ State Cancer Registry staff (for the NJ site). Controls residing in the same areas are identified by random digit dialing and, in NJ, also through community recruiting. Data collection, through an in-person interview includes completion of several behavioral questionnaires, including a food frequency questionnaire, collection of biospecimens (blood, saliva, and tissue), and body measurements, including body composition. Medical records acquisition and abstraction (for the NJ site) are based at UMDNJ-School of Public Health, where an ancillary study will evaluate determinants of disparities in treatment.

As of June 2010, a total of 1,618 cases (759 AA and 859 EA) and 1,674 controls (790 AA and 884 EA) have completed the study in the two recruiting sites. Preliminary analyses revealed some important differences between AA and EA cases, with AA women being more likely to be obese (52.4% vs. 26.8%), not to ever have had a screening mammogram after age 40 yrs. (15.3% vs. 6.6%), and not to have health insurance (14.2% vs. 3.8%). The method of first detection of their breast cancer also differed by race. Among cases over 40, AA women were more likely to first find it accidentally or by routine self-exam than EA women (44% vs. 27.7%), whereas detection by mammogram or physical exam was less common among AA women (48.8% vs. 62.1 %). Consistent with other studies, AA cases were more likely to have high-grade tumors (52.2% vs. 34.7%) with ER negative (32.6% vs. 30.9%) and PR negative (46.2% vs. 30.3%) status. Recruitment in NY was closed in December 2008 with planned enrollment in NJ through November 2010. By then, we will have a rich data biorepository that will allow us to address novel hypotheses aimed at reducing disparities in breast cancer etiology and treatment.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A83.