Race and breast cancer
July 10, 2007 8:48 AM   Subscribe

A link between race and breast cancer. The findings of this study by a Philadelphia research team dovetail other recent findings, including those of Chicago researcher Funmi Olopade, a MacArthur winning doctor from Nigeria who is studying the genetic implications of the discovery. A Q & A with Dr. Olopade on her research. Dr. Olopade discussing her work on the Tavis Smiley show in 2003.
posted by The Straightener (7 comments total) 1 user marked this as a favorite
 
I'll say it for those concerned about an increased focus on race to make genetic and treatment based generalizations. What is black in this situation? It seems to be very specific in the case of the triple negative breast cancer described within: African American women descended from slaves taken from a specific West African region.

While Dr. Olopade is very clear about this West African founding effect, I see that several articles make the general blanket label of "black." While this might go well with the majority of African American women in the United States, I wonder if these more lethal cancers exist in other African populations?

I wonder if people worry if people will divide whites into "less lethal" breast cancer and blacks into "more lethal" breast cancer groups. What about the exceptions to the generalizations? White women with the triple negative form. Or with black ancestry? Or an African American not descended from slave populations? Is cancer research advanced enough to truly test the individual for these sorts of things?

I can understand why it might be useful, for the purpose of research, dividing things racially. Maybe it's easier to study things if you categorize them widely. But is it okay to broadly apply that research to groups that have very complex variation despite their monolithic racial classification?

That said, isn't it the responsibility of medicine to do whatever possible to help combat cancer? The earlier you treat cancer, the better. Is it feasible to tailor treatment based on individual variation right now, or would dividing things by race currently provide the most benefit?

I guess this subject just makes me want to ask a lot of questions.
posted by Mister Cheese at 9:26 AM on July 10, 2007


Is it feasible to tailor treatment based on individual variation right now, or would dividing things by race currently provide the most benefit?

I would think this kind of research would provide caveats to a larger population and create better awareness. It is true that African American's are more prone to diseases such as Sickle Cell Anemia and research has supported this. With Cancer, there're so many exceptions and tons unforeseen cases. This is an interesting study because it's geared to begin providing answers and medical technology for those apart of the imbalance.
posted by Viomeda at 10:19 AM on July 10, 2007


Why divide things by "race"? It's a genetic variation, not a skin-color-based one. If there's a provable link between a genetic marker and a disease condition, it seems like it would make more sense to use a genetic test that looks directly for the marker, instead of basing treatment decisions off of a different genetic trait (or set of traits) that may not occur 1:1 with the disease-related marker.
posted by Kadin2048 at 10:53 AM on July 10, 2007


"we're looking at whether racism and violence over a lifetime might matter. that is a hypothesis that's being tested, olopade said."

doctor, i don't think anything in your bag can reach the green from here.
posted by bruce at 11:34 AM on July 10, 2007


Despite all the noise above, a surgical oncologist friend of mine in Dublin is extraordinarily grateful for this work. The huge and sudden increase in the Nigerian population in North inner city Dublin has skewed his "normal" Breast cancers and it was fundamental in interveneing early that he had access to the research mentioned.
Woman's lives will have been saved, once the 5 year and 10 year data is in, of that I have no doubt.

So political considerations aside for one Joe Soap Surgeon and his patients this rocks!
posted by Wilder at 12:38 PM on July 10, 2007


Where are your ancestors from? What is your genotype? Which of these questions would your rather answer if your life depended on getting the answer right?

If we knew all the trouble spots for all the diseases and had incredibly rapid DNA sequencing, we could all know exactly what markers we had and what diseases (cancer and otherwise) we should be especially wary of.

In the here and now we are more likely to know what our ethnicity is and that people of that ethnicity are more prone to this or that disease. It's not perfect, but if my not dying is based on my going to the doctor when I get a certain symptom rather than ignoring it until it gets worse, I'll take it.
posted by Kid Charlemagne at 2:18 PM on July 10, 2007


Is it feasible to tailor treatment based on individual variation right now...

The company I work at is trying to do exactly that, by attempting to find "marker" proteins that correlate with a patient's chances of responding or not to a particular drug. (In many cases, cancer patients are started on the therapy that works best, statistically speaking, even though it's known that many people won't respond. The non-responders can be in for a world of hurt because they suffer nasty side effects for no purpose and meanwhile their cancer keeps progressing.) Anyway, we've never once discussed race as a factor - it's all about the molecules, baby.

I suppose in the absence of real analytical methods, a rough correlation of clinical prognosis with race is better than nothing. But race is such a poorly-defined characteristic that it's virtually impossible to treat it quantitatively, as you would need to for a real diagnostic/prognostic method.

As an aside, it's not all in the DNA - it's beginning to look as though post-translational modifications play a large role in determining the course of a disease. Yeah, the control of the PTMs ultimately is at the DNA level, but knowing that a particular kinase is upregulated doesn't necessarily tell you which target proteins will be phosphorylated because the pathways interconnect and modulate each other. You have to look at the proteins themselves. It's a pity, because DNA is so much easier!
posted by Quietgal at 7:33 PM on July 10, 2007


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