Breast cancer mortality among Ashkenazi Jewish women in S？o Paulo and Porto Alegre, Brazil

We reviewed all death certificates archived in the Jewish Burial Societies of S？o Paulo (1971-1997) and Porto Alegre (1948-1997), two of the main and oldest Jewish communities in Brazil. Breast cancer observed deaths were compared with expected deaths according to breast cancer mortality in the general population.The observed ratios were approximately quite close to unity, suggesting a similar breast cancer mortality pattern among the Ashkenazi population and the general population in both cities. These results maintain similar behavior regardless of whether analyzed before or after the mid-1980s, when mammography came to be increasingly performed in Brazil. Cancer proportional mortality ratios were 1.04 (0.83-1.29) in S？o Paulo and 1.16 (0.84-1.57) in Porto Alegre before 1985, and 1.17 (1.00-1.44) and 1.21 (0.81-1.79), respectively, between 1985 and 1997. Some evidence of the maintenance of protective risk factors such as high parity has been observed among Ashkenazi women in S？o Paulo.A quite similar breast cancer mortality pattern was observed between Ashkenazi Jewish women and the general population in S？o Paulo and Porto Alegre, Brazil. These results may suggest an environmental role on germ mutation expression reported in this ethnic group.The understanding of the role of several cancer risk factors has been enhanced by the analysis of their distribution in different ethnic groups, as observed in several sites such as the brain, colon, breast, ovary and others. Despite the fact that some genetic differences have been identified, ethnic differences more often point out differences in the patterns of environmental exposures such as diet and other lifestyle-related factors.Several studies carried out in the past decade have reported higher rates of BRCA1 and BRCA2 gene mutations (mainly 185 delAG, 5382insC and 6174delT) in Ashkenazi (Eastern and Central Europe ancestry) Jewish women than in the general population in different countries [1,2,3,4,5,6]. This fact ha