Understanding breast cancer management in women of different ethnicities
The outcomes for patients with breast cancer have improved significantly over the last few decades, largely due to early detection and diagnosis and better treatments. However, differences in outcomes are still observed to persist in different groups of women e.g. ethnic minority women, and the reasons for these differences are not fully understood but may be due to differences in treatment received.
A new study recently published in the British Journal of Surgery led by Dr Toral Gathani has investigated this question, using data on over 164 000 women with breast cancer from the National Cancer Registration and Cancer Analysis Service at Public Health England. They found that there were no significant differences in the surgical management of early breast cancer, in women of different ethnicities.
Women in ethnic minority groups were more likely than white women to undergo mastectomy than breast-conserving surgery for their breast cancer, but these differences were largely explained by differences in age and stage at presentation. Ethnic minority women were on average younger and more likely to have a higher stage disease at presentation compared to White women. These differences in age and stage at presentation are likely to be a reflection of the age structure of migrant populations and differences in health seeking behaviour.
The next step for Dr Gathani is to investigate the associations of ethnicity and the tumour characteristics of breast cancer, including factors such as tumour grade and receptor profile, to try and further explain some of the differences in observed outcomes.
Dr Toral Gathani says:
“Women from ethnic minorities represent a younger group generally, and as such may benefit from targeted public health messaging in their communities with regard to breast health, to encourage more cancer awareness and seeking of early referral to healthcare services, with reassurance that once they engage with the system they are treated similarly.
“Healthcare professionals working in ethnically dense areas of the country need to be cognisant of the different patterns of presentation of breast cancer in women of different ethnicities and be encouraged to engage in early referral to secondary care where appropriate.”
About the research
This research was funded by Cancer Research UK.
Dr Toral Gathani is a Senior Clinical Research Fellow at the Nuffield Department of Population Health and a Consultant Breast Surgeon in Oxford University Hospitals NHS Foundation Trust. Her primary areas of interest are in the epidemiology, outcomes and experiences of breast cancer in women of different ethnicities in the UK and of non-communicable disease in general, and breast cancer in particular, as a global health concern.