Should Breast Cancer Treatment Be Different for Native American Women?

Although rates of breast cancer are lower in Native American women than white women, Native American women are more likely to die from the disease. Research suggests that barriers to screening, treatment, and research, as well as chronic stress and poverty, play a role in this disparity. A new analysis of the genetics of breast cancer in Native American women may point to another contributing factor.

The study found that breast cancer samples from Native American women have mutations in different genes from breast cancer in white women, which could alter how effective certain treatments are.

“The largest breast cancer database in the world, the Cancer Genome Atlas, contains more than a thousand breast cancer patients — and only one of them is Native American,” Jun Li, PhD, a study author and professor of applied and computational mathematics and statistics at Notre Dame, said in a statement. “That means today’s treatments and tests have effectively been built using data from other populations, and then assumed to work equally well for everyone.”

Many of the genetic mutations in breast cancer in Native American women, including mutations in the NOTCH4 and HLA-DRB1 genes, are related to the immune system. Mutations in these genes make it difficult for the immune system to recognize cancer cells.

These unique mutations may affect how breast cancer responds to treatment in Native American women, which may help explain why they are more likely to die from the disease than white women. The number of Native American breast cancer samples in the study was relatively small (17 women). The researchers said their work isn’t intended to change how breast cancer is treated, and that more research is needed to help tease out all the factors that affect  breast cancer outcomes in Native American women, including environmental and socioeconomic conditions.