title: Breast cancer histology and receptor status characterization in Asian Indian and Pakistani women in the U.S.--a SEER analysis.
abstract: BACKGROUND
  Recent reports suggest increase in estrogen receptor (ER), progesterone receptor (PR) negative breast cancer yet little is known about histology or receptor status of breast cancer in Indian/Pakistani women.in the U.S.
  
  
  METHODS
  We examined the United States National Cancer Institute's Surveillance Epidemiology and End Results (SEER) Cancer program to assess: a) frequency of breast cancer by age, b) histologic subtypes, c) receptor status of breast cancer and, d) survival in Indians/Pakistanis compared to Caucasians. There were 360,933 breast cancer cases diagnosed 1988-2006. Chi-Square analyses and Cox proportional hazards models, to estimate relative risks for breast cancer mortality after adjusting for confounders, were performed using Statistical Analysis Software 9.2.
  
  
  RESULTS
  Among Asian Indian/Pakistani breast cancer patients, 16.2% were < 40 yrs. old compared to 6.23% in Caucasians (p < 0.0001). Asian Indian women had more invasive ductal carcinoma (69.1 vs. 65.7%, p < 0.0001), inflammatory cancer (1.4% vs. 0.8, p < 0.0001) and less invasive lobular carcinoma (4.2% vs. 8.1%, p < 0.0001) than Caucasians. Asian Indian/Pakistani women had more ER/PR negative breast cancer (30.6% vs. 21.8%, p = 0.0095) than Caucasians. Adjusting for stage at diagnosis, age, tumor grade, nodal status, and histology, Asian Indian/Pakistani women's survival was similar to Caucasians, while African Americans' was worse.
  
  
  CONCLUSIONS
  Asian Indian/Pakistani women have higher frequency of breast cancer (particularly in age < 40), ER/PR negative invasive ductal and inflammatory cancer than Caucasians.
authors.affiliation: Division of Hematology/Oncolog, Department of Internal Medicine, University of Michigan, 2150 Cancer Center, 1500 E Medical Center Drive, Ann Arbor, MI 48109-5390, USA. mkakaral@umich.edu
authors.forename: Madhuri
authors.initials: M
authors.lastname: Kakarala
authors.forename: Laura
authors.initials: L
authors.lastname: Rozek
authors.forename: Michele
authors.initials: M
authors.lastname: Cote
authors.forename: Samadhi
authors.initials: S
authors.lastname: Liyanage
authors.forename: Dean E
authors.initials: DE
authors.lastname: Brenner
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000453:epidemiology / Q000208:ethnology* / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D007194:India / Q000208:ethnology; D008875:Middle Aged; D009367:Neoplasm Staging; D010154:Pakistan / Q000208:ethnology; D016016:Proportional Hazards Models; D011960:Receptors, Estrogen / Q000096:biosynthesis*; D011980:Receptors, Progesterone / Q000096:biosynthesis*; D018426:SEER Program; D014481:United States / Q000453:epidemiology
chemical_list: D011960:Receptors, Estrogen; D011980:Receptors, Progesterone
references.citation: Soz Praventivmed. 2000;45(6):247-57
references.pmid: 11210595
references.citation: J Clin Epidemiol. 2009 Jun;62(6):660-6
references.pmid: 19070463
references.citation: Breast Cancer Res Treat. 2007 Jan;101(1):3-6
references.pmid: 17131039
references.citation: Cancer Res. 2009 Apr 15;69(8):3589-96
references.pmid: 19351835
references.citation: Br J Cancer. 2006 Nov 20;95(10):1334-41
references.pmid: 17088909
references.citation: Int J Cancer. 2002 Jun 10;99(5):747-50
references.pmid: 12115511
references.citation: Int J Cancer. 2009 Oct 1;125(7):1663-70
references.pmid: 19452528
references.citation: Cancer Epidemiol Biomarkers Prev. 2005 Jan;14(1):41-7
references.pmid: 15668474
references.citation: Cancer Detect Prev. 2009;32(5-6):386-94
references.pmid: 19588543
references.citation: Cancer Sci. 2009 Jun;100(6):1105-11
references.pmid: 19320639
references.citation: JAMA. 2006 Jun 7;295(21):2492-502
references.pmid: 16757721
references.citation: Breast Cancer Res Treat. 2008 Jul;110(1):183-8
references.pmid: 17674190
references.citation: Nutr Cancer. 1999;35(1):16-26
references.pmid: 10624702
references.citation: J Surg Oncol. 2006 Aug 1;94(2):105-13
references.pmid: 16847919
references.citation: Cancer Detect Prev. 2006;30(1):58-66
references.pmid: 16458452
references.citation: Mol Cancer Ther. 2008 Dec;7(12):3695-706
references.pmid: 19056674
references.citation: Breast Cancer Res. 2006;8(6):R66
references.pmid: 17129383
references.citation: Nat Clin Pract Oncol. 2007 Sep;4(9):516-25
references.pmid: 17728710
references.citation: Anticancer Res. 1984 Nov-Dec;4(6):403-7
references.pmid: 6097160
references.citation: BMC Cancer. 2007 Nov 01;7:203
references.pmid: 17976237
references.citation: Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2009 Mar;153(1):13-7
references.pmid: 19365520
references.citation: Indian J Pathol Microbiol. 2009 Apr-Jun;52(2):171-4
references.pmid: 19332904
references.citation: Clin Cancer Res. 2008 Aug 15;14(16):5158-65
references.pmid: 18698033
references.citation: Int J Epidemiol. 2008 Feb;37(1):147-60
references.pmid: 18094016
references.citation: Am J Surg. 2002 Dec;184(6):492-8; discussion 498
references.pmid: 12488144
references.citation: Cancer Res. 2006 Nov 1;66(21):10292-301
references.pmid: 17079448
references.citation: Asian Pac J Cancer Prev. 2006 Oct-Dec;7(4):547-55
references.pmid: 17250425
references.citation: Cancer Control. 1994 Jul;1(4):327-333
references.pmid: 10886983
references.citation: Clin Cancer Res. 2007 Apr 15;13(8):2329-34
references.pmid: 17438091
references.citation: Breast Cancer. 2009;16(4):252-3
references.pmid: 19506994
references.citation: J Surg Oncol. 2005 Mar 15;89(4):251-5
references.pmid: 15726618
references.citation: CA Cancer J Clin. 2009 Jul-Aug;59(4):225-49
references.pmid: 19474385
references.citation: Cancer Causes Control. 2009 Jul;20(5):635-43
references.pmid: 19067192
references.citation: Cancer. 2007 May 1;109(9):1721-8
references.pmid: 17387718
references.citation: Lakartidningen. 2000 Jan 26;97(4):294-9
references.pmid: 10684222
references.citation: J Surg Res. 2007 Nov;143(1):109-18
references.pmid: 17950079
references.citation: Eur J Obstet Gynecol Reprod Biol. 2008 Dec;141(2):147-52
references.pmid: 18768247
references.citation: Cancer Res. 2005 Mar 15;65(6):2170-8
references.pmid: 15781628
references.citation: J Am Diet Assoc. 1999 Oct;99(10):1275-7
references.pmid: 10524396
references.citation: Breast Cancer Res Treat. 2006 Feb;95(3):243-55
references.pmid: 16261404
references.citation: Clin Chim Acta. 1994 Sep;229(1-2):107-22
references.pmid: 7988041
references.citation: Trop Geogr Med. 1989 Jul;41(3):257-60
references.pmid: 2556824
references.citation: Breast J. 2008 Jul-Aug;14(4):402-3
references.pmid: 18540951
references.citation: J Surg Oncol. 1989 Dec;42(4):256-63
references.pmid: 2593668
references.citation: Jpn J Clin Oncol. 2006 Jun;36(6):399-400
references.pmid: 16818481
references.citation: Cancer Epidemiol Biomarkers Prev. 2009 Jun;18(6):1807-14
references.pmid: 19505913
references.citation: Eur J Cancer. 2004 Dec;40(18):2667-75
references.pmid: 15571950
references.citation: Indian J Pathol Microbiol. 2005 Apr;48(2):199-201
references.pmid: 16758664
references.citation: Hum Mutat. 2002 Dec;20(6):473-4
references.pmid: 12442273
references.citation: BMC Med Genet. 2006 Oct 04;7:75
references.pmid: 17018160
references.citation: Asian Pac J Cancer Prev. 2007 Oct-Dec;8(4):507-12
references.pmid: 18260720
references.citation: Eur J Cancer Care (Engl). 2007 Mar;16(2):185-6
references.pmid: 17371429
references.citation: BMC Cancer. 2008 Jan 29;8:28
references.pmid: 18230143
references.citation: Breast Cancer Res. 2006;8(1):R11
references.pmid: 16507159
references.citation: J Biosci. 2000 Mar;25(1):19-23
references.pmid: 10824194
references.citation: Ann Surg. 2008 Jan;247(1):143-9
references.pmid: 18156934
references.citation: Clin Cancer Res. 2008 Mar 1;14(5):1368-76
references.pmid: 18316557
references.citation: Am J Clin Pathol. 2008 Sep;130(3):414-24
references.pmid: 18701415
references.citation: Clin Med Res. 2009 Jun;7(1-2):4-13
references.pmid: 19574486
references.citation: Br J Cancer. 2009 Feb 10;100(3):545-50
references.pmid: 19127253