Share This Article:

Comparative study of breast cancer in Mexican and Mexican-American women

Full-Text HTML Download Download as PDF (Size:832KB) PP. 1040-1048
DOI: 10.4236/health.2010.29153    7,117 Downloads   13,588 Views   Citations
Author(s)    Leave a comment
María Elena Martínez, Luis Enrique Gutiérrez-Millan, Melissa Bondy, Adrian Daneri-Navarro, María Mercedes Meza-Montenegro, Ivan Anduro-Corona, Ma Isabel Aramburo-Rubio, Luz María Adriana Balderas-Peña, José Adelfo Barragan-Ruiz, Abenaa Brewster, Graciela Caire-Juvera, Juan Manuel Castro-Cervantes, Mario Alberto Chávez Zamudio, Giovanna Cruz, Alicia Del Toro-Arreola, Mary E. Edgerton, María Rosa Flores-Marquez, Ramon Antonio Franco-Topete, Helga Garcia, Susan Andrea Gutierrez-Rubio, Karin Hahn, Luz Margarita Jimenez-Perez, Ian K. Komenaka, Zoila Arelí López Bujanda, Dihui Lu, Gilberto Morgan-Villela, James L. Murray, Jesse N. Nodora, Antonio Oceguera-Villanueva, Miguel Angel Ortiz Martínez, Laura Pérez Michel, Antonio Quintero-Ramos, Aysegul Sahin, Jeong Yun Shim, Maureen Stewart, Gonzalo Vazquez-Camacho, Betsy Wertheim, Rachel Zenuk, Patricia Thompson


Breast cancer is the number one cause of can- cer deaths among Hispanic women in the United States, and in Mexico, it recently became the primary cause of cancer deaths. This malign- nancy represents a poorly understood and un- derstudied disease in Hispanic women. The ELLA Binational Breast Cancer Study was es- tablished in 2006 as a multi-center study to as- sess patterns of breast tumor markers, clinical characteristics, and their risk factors in women of Mexican descent. We describe the design and implementation of the ELLA Study and provide a risk factor comparison between women in the U.S. and those in Mexico based on a sample of 765 patients (364 in the U.S. and 401 in Mexico). Compared to women in Mexico, U.S. women had significantly (p < 0.05) lower parity (3.2 vs. 3.9 mean live births) and breastfeeding rates (57.5% vs. 80.5%), higher use of oral contraceptives (60.7% vs. 50.1%) and hormone replacement therapy (23.3% vs. 7.6%), and higher family history of breast cancer (15.7% vs. 9.0%). Re- sults show that differences in breast cancer risk factor patterns exist between Mexico and U.S. women. We provide lessons learned from the conduct of our study. Binational studies are an important step in understanding disease pat- terns and etiology for women in both countries.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Martínez, M. , Gutiérrez-Millan, L. , Bondy, M. , Daneri-Navarro, A. , Meza-Montenegro, M. , Anduro-Corona, I. , Aramburo-Rubio, M. , Balderas-Peña, L. , Barragan-Ruiz, J. , Brewster, A. , Caire-Juvera, G. , Castro-Cervantes, J. , Zamudio, M. , Cruz, G. , Toro-Arreola, A. , Edgerton, M. , Flores-Marquez, M. , Franco-Topete, R. , Garcia, H. , Gutierrez-Rubio, S. , Hahn, K. , Jimenez-Perez, L. , Komenaka, I. , Bujanda, Z. , Lu, D. , Morgan-Villela, G. , Murray, J. , Nodora, J. , Oceguera-Villanueva, A. , Martínez, M. , Michel, L. , Quintero-Ramos, A. , Sahin, A. , Shim, J. , Stewart, M. , Vazquez-Camacho, G. , Wertheim, B. , Zenuk, R. and Thompson, P. (2010) Comparative study of breast cancer in Mexican and Mexican-American women. Health, 2, 1040-1048. doi: 10.4236/health.2010.29153.


[1] Parkin, D. M. (2002) Cancer incidence in five continents. In: Parkin, D.M., Whelan, S.L., Ferlay, J., Teppo, L. and Thomas, D.B., Eds., IARC, World Health Organization, 8.
[2] Lozano-Ascencio, R., Gomez-Dantes, H., Lewis, S., et al. (2009) Breast cancer trends in Latin America and the Caribbean (Spanish). Salud Publica de Mexico, 51(Suppl. 2), S147-S156.
[3] Knaul, F.M., Arreola-Ornelas, H., Velazquez, E., et al. (2009) The health care costs of breast cancer: The case of the Mexical Social Security Insitute (Spanish). Salud Publica Mexico, 51(Suppl. 2), S286-S295.
[4] Smigal, C., Jemal, A., Ward, E., et al. (2006) Trends in breast cancer by race and ethnicity: Update 2006. A Cancer Journal for Clinicians, 56(3), 168-183.
[5] Howe, H.L., Wu, X. and Ries, L.A. (2006) Annual report to the nation on the status of cancer, 1975-2003, featuring cancer among U.S. Hispanic/Latino Populations. Cancer, 107(8), 1711-1742.
[6] Hedeen, A.N. and White, E. (2001) Breast cancer size and stage in Hispanic American women, by birthplace: 1992-1995. American Journal of Public Health, 91(1), 122-125.
[7] Elledge, R.M., Clark, G.M., Chamness, G.C., et al. (1994) Tumor biologic factors and breast cancer prognosis amont white, Hispanic, and black women in the United States. Journal of National Cancer Institute, 86(9), 705- 712.
[8] Shavers, V.L., Harlan, L.C. and Stevens, J.L. (2003) Racial/ethnic variation in clinical presentation, treatment, and survival among breast cancer patients under 35. Cancer, 97(1), 134-147.
[9] Miller, B.A., Hankey, B.F. and Thomas, T.L. (2002) Impact of sociodemographic factors, hormone receptor status, and tumor grade on ethnic differences in tumor stage and size for breast cancer in US women. American Journal of Epidemiology, 155(6), 534-545.
[10] Lantz, P.M., Mujahid, M., Schwartz, K., et al. (2006) The influence of race, ethnicity and individual socioeconomic factors on breast cancer state at diagnosis. American Journal of Public Health, 96(12), 2173-2178.
[11] Martinez, M.E., Nielson, C.M., Nagle, R., et al. (2007) Breast cancer among Hispanic and non-Hispanic White Women in Arizona. Journal of Health Care for the Poor and Underserved, 18(Suppl. 4), 130-145.
[12] Pike, M.C., Kolonel, L.N., Henderson, B.E., et al. (2002) Breast cancer in a multiethnic cohort in Hawaii and Los Angeles: Risk factor-adjusted incidence in Japanese equals and in Hawaiians exceeds that in Whites. Cancer Epidemiology, Biomarkers & Prevention, 11(9), 795-800.
[13] Risendal, B., Hines, L.M., Sweeney, C., et al. (2008) Family hisotry and age at onset of breast cancer in Hispanic and non-Hispanic white women. Cancer Causes Control, 19(10), 1349-1355.
[14] Slattery, M.L., Sweeney, C., Edwards, S., et al. (2007) Body size, weight change, fat distribution and breast cancer risk in Hispanic and non-Hispanic white women. Breast Cancer Research and Treatment, 102(1), 85-101.
[15] Slattery, M.L., Edwards, S., Murtaugh, M.A., et al. (2007) Physical activity and breast cancer risk among women in the Southwestern United States. Annals of Epidemiology, 17(5), 342-353.
[16] John, E. M., Horn-Ross, P. L. and Koo, J. (2003) Lifetime physical activity and breast cancer risk in a multiethnic population: the San Francisco Bay area breast cancer study. Cancer Epidemiology, Biomarkers & Prevention, 12(11), 1143-1152.
[17] Sweeney, C., Giuliano, A.R., Baumgartner, K.B., et al. (2007) Oral, injected and implanted contraceptives and breast cancer risk among U.S. Hispanic and non-Hispanic white women. International Journal of Cancer, 121(11), 2517-2523.
[18] Murtaugh, M.A., Sweeney, C., Giuliano, A.R., et al. (2008) Diet patterns and breast cancer risk in Hispanic and non-Hispanic white women: The four-corners breast cancer study. American Journal of Clinical Nutrition, 87(4), 978-984.
[19] John, E.M., Phipps, A.I., et al. (2005) Migration history, acculturation, and breast cancer risk in Hispanic women. Cancer Epidemiology, Biomarkers & Prevention, 14(12), 2905-2913.
[20] Sorlie, T., Tibshirani, R., Parker, J., et al. (2003) Repeated observation of breast tumor subtypes in independent gene expression data sets. Proceedings of the National Academy of Sciences, 100(14), 8418-8423.
[21] Thompson, P.T., Lopez, A.M. and Stopeck, A. (2008) Breast Cancer Prevention. In: Alberts, D.S. and Hess, L.M., Eds., Fundamentals of Cancer Prevention, 2nd Edition, Springer, New York, 255-276.
[22] Perou, C.M., Sorlie, T., Eisen, M.B., et al. (2000) Molecular portraits of human breast tumours. Nature, 406(6797), 747-752.
[23] Carey, L.A., Perou, C.M., Lvasy, C.A., et al. (2006) Race, breast cancer subtypes, and survival in the Carolina Breast Cancer Study. JAMA, 295(21), 2492-2502.
[24] Rakha, E.A., Elsheikh, S.E., Alekandarany, M.A., et al. (2009) Triple-negative breast cancer: Distinguishing between basal and nonbasal subtypes. Clinical Cancer Research, 15(7), 2302-2310.
[25] Li, C.I., Malone, K.E. and Daling, J.R. (2002) Differences in breast cancer hormone receptor status and histology by race and ethnicity among women 50 years of age and older. Cancer Epidemiology, Biomarkers & Prevention, 11(7), 601-607.
[26] Chu, K.C. and Anderson, W.F. (2002) Rates for breast cancer characteristically by estrogen and progesterone receptor status in the major racial/ethnic groups. Breast Cancer Research and Treatment, 74(3), 199-211.
[27] Setiawan, V.W., Monroe, K.R., Wilkens, L.R., et al. (2009) Breast cancer risk factors defined by estrogen and progesterone receptor status. American Journal of Epidemiology, 169(10), 1251-1259.
[28] Brown, M., Tsodikov, A., Bauer, K.R., et al. (2008) The role of human epidermal growth factor receptor 2 in the survival of women with estrogen and progesterone receptor-negative, invasive breast cancer. Cancer, 112(4), 737-747.
[29] Bauer, K.R., Brown, M., Cress, R.D., et al. (2007) Descriptive analysis of estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and Her2-negative invasive breast cancer, the so-called triple-negative phenotype. Cancer, 109(9), 1721-1728.
[30] Alegria, M. (2009) The challenge of acculturation measures: What are we missing? A commentary on Thomson and Hoffman-Goetz. Social Science & Medicine, 69(7), 996-998.
[31] Hunt, L.M., Schneider, S. and Comer, B. (2004) Should “acculturation” be available in health research? A critical review of research on US Hispanics. Social Science & Medicine, 59(5), 973-986.
[32] Carter-Pokras, O. and Bethune, L. (2009) Defining and measuring acculturation: A systematic review of public health studies with Hispanic populations in the United States. A commentary on Thomson and Hoffman-Goetz. Social Science & Medicine, 69(7), 983-991.
[33] Nielsen, T.O., Hsu, F.D., Jensen, K., et al. (2004) Immunohistochemical and clinical characterization of the basal-like subtype of invasive breast carcinoma. Clinical Cancer Research, 10(16), 5367-5374.
[34] U.S. Census Bureau. Hispanic Population of the United States. hispanic/hispanic_pop_presentation.html
[35] Centers for Disease Control and Prevention. National Center for Chronic Disease Prevention and Health Promotion, 2009. Cancer among Women. http://www.cdc. gov/cancer/dcpc/data/women.htm
[36] World Cancer Research Fund/American Institute for Cancer Research (2007) Food nutrition, physical activity and the prevention of cancer: A global perspective. AICR, Washington, D.C.
[37] Romieu, I. and Lajous, M. (2009) The role of obesity, physical activity and dietary factors on the risk of breast cancer: Mexican experience. Salud Publica de Mexico, 51(Suppl. 2), S172-S180.
[38] Centers for Disease Control and Prevention (2009) Differences in prevalence of obesity among black, white, and Hispanic adults—United States, 2006-2008. MMWR, 58(27), 740-744.
[39] Akresh, I.R. (2008) Overweight and obesity among foreign-born and U.S.-born Hispanics. Biodemography and Social Biology, 54(2), 183-199.
[40] Millikan, R.C., Newman, B., Tse, C.K., et al. (2008) Epidemiology of basal-like breast cancer. Breast Cancer Research and Treatment, 109(1), 123-139.
[41] Yang, X.R., Sherman, M.E., Rimm, L., et al. (2007) Differences in risk factors for breast cancer molecular subtypes in a population-based study. Cancer Epidemiology, Biomarkers & Prevention, 16(3), 439-443.
[42] Kwan, M.L., Kushi, L.H., Weltzien, E., et al. (2009) Epidemiology of breast cancer subtypes in two prospective cohort studies of breast cancer survivors. Breast Cancer Research, 11(3), 1-13.
[43] Bayer-Chammard, A., Taylor, T.H. and Anton-Culver, H. (1999) Survival differences in breast caner among racial/ethnic groups: A population-based study. Cancer De- tection and Prevention, 23(6), 463-473.
[44] Instituto Nacional de Estadistica y Geografia. Total population by federal entity: Age displayed and five-year age groups by sex (Spanish). est/contenidos/espanol/sistemas/conteo2005/Default.asp
[45] Mohar, A., Bargallo, E., Ramirez, M.T., et al. (2009) Available resources for the treatment of breast cancer in Mexico (Spanish). Salud Publica de Mexico, 51(Suppl. 2), S263-S269.
[46] Olaiz, G., Rivera, T., Shamah, T., et al. (2006) Health and nutrition national survey 2006 (Spanish). Instituto Nacional de Salud Publica, Cuernavaca.
[47] Frenk, J., Gonzalez-Pier, E, Gomez-Dantes, O., et al. (2006) Health system reform in Mexico 1: Comprehensive reform to improve health system performance in Mexico. Lancet, 368(9539), 1524-1534.

comments powered by Disqus

Copyright © 2018 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.