By: Angela C. Darko, M.D. (November 3, 2009)
 October was breast cancer awareness month, and pink was in the air! It is now November, and those not directly affected by the disease, that is one of the deadliest killers of women, have moved on. They will become interested in all things pink again next October. African women for several reasons cannot afford to forget breast cancer all year round because, according to recent studies, women of African ancestry are at a higher risk of being diagnosed with a more dangerous form of the disease, than women of European ancestry. Breast cancer is known to have different clinical presentations and outcomes based on different ethnic groups. A few researchers such as Lisa Newman M.D. and Funmi Olopade M.D. have been studying breast cancer in women of African descent over the last few years. What they found is that the incidence of breast cancer in African women and women of African descent is lower compared to that of other ethnic groups, but that the age at presentation is earlier and the biology of the disease is usually found to be more aggressive. They arise from different cells in the breast and are usually receptor negative. Some of the targeted receptors and markers in breast cancer are estrogen, progesterone and HER2/NEU over expression. These are important because they can be targeted for drug therapy. However, in triple negative breast cancers that are seen in women of African descent there is nothing to target and they will not respond to drugs currently being used. What all these findings mean for African woman: It means that there may be different genetic factors, risk factors and environmental factors involved in breast cancer in African women. One of the genetic mutations known to be involved in breast cancer is the BRCA gene. This gene mutation has also been observed in African women but there might be other mutations that have not been studied, due to the different biological behavior. Other risk factors such as obesity, alcohol, and no children, family history of breast cancer, abortions, oral contraceptive usage, and lack of physical activity, smoking and many more have been linked to breast cancer. Yet, there are limited studies to confirm the effects on African women. Moreover, having some or all the risk factors does not necessarily mean women will develop breast cancer. What African Women Can Do: We have to be aware of the disease and try to follow preventative measures that will either decrease the risk, or aid in early detection and treatment. Currently, screening mammography is not routinely done in younger women, but monthly self-breast examination is helpful in finding lumps that can be brought to the attention of your primary care physician. The most important thing is early detection, the sooner it is found the better the outcome. It decreases the chances of distant metastasis. Currently, in Ghana where some of these studies are being done, women are being made aware of breast cancer. Nurses in rural settings are being trained to recognize breast lumps suspicious for cancer and triaging women to the main hospitals for care. In westernized countries, a woman can get breast exams during her annual gynecologic visit, and also learn how to do frequent personal breast exams. There are many resources out there from places like the Susan G. Komen website and the American Cancer Society. Use your resources and be informed and share what you find with your sisters. You could save a life. 
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