Gene Mutation Worsens

Breast Cancer in Blacks

Black women with breast cancer are much more likely than white women to have a genetic mutation that makes their cancer more dangerous, researchers reported yesterday.

The report, published in the journal Cancer, may help explain why black women are more likely than white women to die of the disease even though they are less likely to develop breast cancer in the first place.

Doctors and other health experts have long assumed it was because black women seek care later and because of differences in lifestyle.

Beth Jones of the Yale University School of Medicine in Connecticut and colleagues studied the breast tumors of 145 black and 177 white women and found significant differences in mutations in p53, a gene known for its involvement in a range of cancers.

Jones's team looked at other genes involved in breast cancer and found no significant ethnic differences.

Many Elderly Patients Being

Prescribed Wrong Drugs

One in five elderly Americans filled prescriptions for drugs deemed inappropriate for older patients, a study of 1999 insurance claims said yesterday.

Of the 765,000 patients ages 65 or older included in the study, nearly 20 percent ordered two or three drugs "of concern," wrote lead author Lesley Curtis of Duke University Medical Center in Durham.

The drugs that were commonly mis-prescribed included two antidepressants, amitriptyline and doxepin, according to the article published in the Archives of Internal Medicine.

In an accompanying editorial, Knight Steel of Hackensack University Medical Center in New Jersey called the rate of errors, even if exaggerated, "a significant failure in the American health care system."

Steel suggested a computerized system to help pharmacists by drawing attention to possibly inappropriate drugs or dosages.

Heart Attacks Without Pain

In Chest May Mislead Doctors

Heart attack patients who do not have chest pains are three times as likely to die, probably because doctors do not recognize their symptoms, researchers reported yesterday.

An estimated 13 percent of patients without chest pain died in the hospital, compared with 4.3 percent of patients with chest pain, according to the study published in the journal Chest.

The patients who died tended to be older women, the international team of researchers found.

"While the majority of people who have acute coronary syndromes, such as heart attacks and unstable angina, feel chest pain, some do not, but, instead, may experience atypical symptoms of fainting, shortness of breath, excessive sweating, or nausea and vomiting" said David Brieger of Concord Hospital in Sydney, who led the study.

Patients without chest pain tended to be older women with diabetes, heart failure or high blood pressure. Patients who suffered chest pain were more likely to be smokers with clogged arteries.

Brieger and colleagues studied the cases of more than 20,000 patients from 14 countries including the United States, Canada, Australia, Britain and France.

-- From News Services