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Breast cancer prognosis for poorer women explained

Researchers have established a link between deprivation and the p53 gene that explains why women from poorer backgrounds are less likely to survive breast cancer.

A team from the University of Dundee has stated that p53 mutation in breast cancer is associated with socioeconomic deprivation and that this helps account for the poorer prognosis for women from deprived communities.

The reasons for differing breast cancer survival rates in poorer areas and in affluent areas (the ‘deprivation gap’) has never been fully understood. Dr Lee Baker, of the Department of Surgery and Molecular Oncology, suggested examining the p53 gene as a candidate molecular marker, and his team found that women from deprived backgrounds were more likely to experience a mutation of p53, which linked to higher relapse and mortality rates.

‘There are two ways that p53 mutations can come about,’ explained Dr Baker. ‘One is as a result of genetic predisposition, and the other is as a result of lifestyle. Smoking, drinking, poor diet, etc., can lead to p53 mutations and are more common in women from lower socioeconomic groups, who are also more likely to experience a recurrence of the disease and to die as a result of breast cancer.

‘This research… shows that successfully creating a treatment for p53 mutation will go a long way down the road to finding a cure for this form of breast cancer. Deprivation alone doesn’t cause breast cancer, but can affect prognosis when p53 is damaged as a result of lifestyle choices commonly associated with deprivation.’

The survey looked at 246 women who underwent treatment for breast cancer between 1997 and 2001. Examining frozen tissue, tests were carried out to determine p53 mutation status. Using the patients’ postcodes, a deprivation score was attributed to each and examined against the outcome.

Patients in the lowest socioeconomic group were significantly more likely to have a relapse and die than those in more affluent categories. The study also demonstrated that the worse survival and shorter disease-free interval in breast cancer for the most deprived patients is associated with tumour p53 mutation. The paper appears in this month’s British Journal of Cancer.

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