1. TRIPLE NEGATIVE BREAST CANCER (TNBC) & ETHNIC MINORITIES

2. What is TNBC
Each type of cancer is defined by the presence of certain hormone receptors
These are Oestrogen (ER), Progesterone (PR) and Human Epidermal Growth Factor Receptor (HER2)
The term ‘’triple negative’’ is an immunohistochemical description arising from a triple negative staining for the ER, PR and HER2 receptors
Class
Receptor Status
Luminal A
ER+ and/or PR+, HER2-
Luminal B
ER+ and/or PR+, HER2+
Triple Negative/Basal Like
ER-, PR-, HER2-
HER2
ER-, PR-, HER2+
Normal Breast Like Tumours
Unclassified (expression similar to that of normal breast tissue and benign tumours)

3. Incidence and Prognosis
TNBC accounts for 12 – 17% of breast cancer cases
Most frequently observed in younger non-Caucasion obese women
Has the worst outcome of all the subtypes
As a result, a TNBC diagnosis is described as a ‘’death sentence’’ by some patients

4. Ethnicity and Triple Negative Breast Cancer
Ethnicity and disease has been a focal point
Age and ethnicity have been identified as independent factors
TNBC has been widely researched in the past decade
Is it a coincidence that black women are most commonly diagnosed with the subtype that has the worst prognosis?

5. Research Carol Parise et al, USA, 2010
study of 69,358 women with primary invasive breast cancer
African-American women more likely to develop the triple negative subtype than Caucasian women and Asian women are more likely to develop the HER2 subtype

6. Research Helen Swede et al, USA, 2011 Carried out surveillance study
found that compared with white patients, black patients had nearly 3 times more prevalence of triple negative breast cancer, and almost double the rate of HER2+.

7. Research Ruth Jack et al, UK, 2013
used electronic pathology reports from 2005 – 2007
patients under the age of 60, Black women were more likely to have TNBC than Caucasian women
South Asian women were also more like to have Triple Negative Breast cancer than Caucasian women
One of the rare UK research carried out

8. Contributing factors?
Different ethnic groups have different lifestyles, originate from different genomic groups and react differently to breast cancer screening, diagnosis and treatment
Established that lifestyle factors contribute to the likeliness of developing cancer such as; smoking and higher levels cholesterol.
With this in mind, and taking into account some of the ethnic groups in the UK, one can assume that for example; South Asians could be more likely to develop cancer alongside coronary heart disease due to high levels of cholesterol in their diets.

9. Are Ethnic Minorities more likely to develop TNBC?
Complete study using UK data
Lack of data
A systemic review
Extrapolate and relate studies from USA and Asia Pacific
Small sub-study on recently collected data
Carry out a complete study at some point here in the UK

10. Conclusion Definite link between ethnic minorities and TNBC
Expose and investigate the link here in the UK
May give rise to better screening and diagnosis methods
Better treatment and prognosis for TNBC patients