Breast cancer characteristics at diagnosis and survival among Arab-American women compared to European- and African-American women.
BACKGROUND
Data from Arab world studies suggest that Arab women may experience a more aggressive breast cancer phenotype. To investigate this finding, we focused on one of the largest settlements of Arabs and Iraqi Christians (Chaldeans) in the US, metropolitan Detroit- a SEER reporting site since 1973.


METHODS
We identified a cohort of primary breast cancer cases diagnosed 1973-2003. Using a validated name algorithm, women were identified as being of Arab/Chaldean descent if they had an Arab last or maiden name. We compared characteristics at diagnosis (age, grade, histology, SEER stage, and marker status) and overall survival between Arab-, European-, and African-Americans.


RESULTS
The cohort included 1,652 (2%) women of Arab descent, 13,855 (18%) African-American women, and 63,615 (80%) European-American women. There were statistically significant differences between the racial groups for all characteristics at diagnosis. Survival analyses overall and for each SEER stage showed that Arab-American women had the best survival, followed by European-American women. African-American women had the poorest overall survival and were 1.37 (95% confidence interval: 1.23-1.52) times more likely to be diagnosed with an aggressive tumor (adjusting for age, grade, marker status, and year of diagnosis).


CONCLUSIONS
Overall, Arab-American women have a distribution of breast cancer histology similar to European-American women. In contrast, the stage, age, and hormone receptor status at diagnosis among Arab-Americans was more similar to African-American women. However, Arab-American women have a better overall survival than even European-American women.
Hensley Alford
Sharon
S
Henry Ford Hospital, Detroit, MI 48202, USA.
Schwartz
Kendra
K
Soliman
Amr
A
Johnson
Christine Cole
CC
Gruber
Stephen B
SB
Merajver
Sofia D
SD
D001741:Black or African American; D018912:Arabs; D014408:Biomarkers, Tumor / Q000378:metabolism; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality*; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality; D018275:Carcinoma, Lobular / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality; D018276:Carcinoma, Medullary / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D012307:Risk Factors; D018426:SEER Program; D015996:Survival Rate; D044465:White People
D014408:Biomarkers, Tumor