title: Functionally active estrogen receptor isoform profiles in the breast tumors of African American women are different from the profiles in breast tumors of Caucasian women.
abstract: BACKGROUND
  Several cancer surveys have shown that African-American women (AAW) develop highly aggressive breast tumors and experience about three times higher mortality rates compared with other populations. Generally, breast tumors in AAW are poorly differentiated or undifferentiated and exhibit increased frequency of nuclear atypia, higher mitotic activity, higher S-phase fraction, and tumor necrosis. The molecular factors responsible for these tumor characteristics are mostly unknown.
  
  
  METHODS
  To explore whether the aggressive tumor biology observed in AAW is related to distinct alterations in estrogen receptor (ER) isoforms, the relative expression levels of four functionally active ER isoform mRNAs, ERalpha wild type, ERbeta wild type, ERalpha exon 3delta, and ERalpha exon 5delta, were measured by reverse transcriptase-polymerase chain reaction analysis in 18 immunohistochemically ERalpha positive tumors and in 6 ERalpha negative tumors and their matched normal tissues.
  
  
  RESULTS
  In the tumors of AAW, the protective ERbeta isoform was decreased significantly compared with matched normal tissues (paired t test; n = 24 patients; P = 0.0018). In addition, both the constitutively active ERalpha exon 5delta and the dominant negative ERalpha exon 3delta mRNA levels were elevated in tumor tissues compared with matched normal tissues (paired t tests; n = 24 patients; P = 0.0002 and P = 0.024, respectively).
  
  
  CONCLUSIONS
  The data presented here show for the first time that functionally active ER isoform profiles in the breast tumors of AAW are different from those in Caucasian women. The tumors in AAW are characterized by decreased levels of the protective ERbeta isoform and elevated levels of the constitutively active ERalpha exon 5delta isoform. Variations in estrogen-mediated signaling because of the alterations in these two ER isoforms may account in part for differences in tumor biology between AAW and Caucasian women.
authors.affiliation: Department of Anatomy, Howard University School of Medicine, Washington, DC 20059, USA. ipoola@howard.edu
authors.forename: Indra
authors.initials: I
authors.lastname: Poola
authors.forename: Robert
authors.initials: R
authors.lastname: Clarke
authors.forename: Robert
authors.initials: R
authors.lastname: DeWitty
authors.forename: LaSelle D
authors.initials: LD
authors.lastname: Leffall
mesh_terms: D044383:Black People; D001943:Breast Neoplasms / Q000208:ethnology / Q000235:genetics / Q000503:physiopathology*; D002471:Cell Transformation, Neoplastic; D004273:DNA, Neoplasm / Q000032:analysis*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007536:Isomerism; D011960:Receptors, Estrogen / Q000032:analysis* / Q000145:classification / Q000502:physiology; D020133:Reverse Transcriptase Polymerase Chain Reaction; D015398:Signal Transduction; D044465:White People; D001741:Black or African American
chemical_list: D004273:DNA, Neoplasm; D011960:Receptors, Estrogen