Several recent reports have shown that the mortality rate with breast cancer is about three times higher in African American women than in other populations. In addition, the available data also indicate that the tumors are very aggressive and poorly differentiated with a very low frequency of hormone receptors. To gain an insight into the factors that may be responsible for their aggressive tumors, we investigated the transcript profiles of the estrogen receptor (ER), the most important prognostic factor in breast cancer, in the tumors derived from African American women. We analyzed 24 immunohistochemically ER+ and 6 ER- malignant tumors for ER mRNA by reverse transcription polymerase chain reaction using a number of primer pairs. For comparative purposes, 20 ER- malignant tumor issues derived from Caucasian patients were also included. Our results showed that only 15 of the ER+ tumors from African American women patients had full-length wild-type receptor transcripts and the others exhibited alterations/truncations in exon 8. We also found that the majority of tumors that had alterations/truncations in exon 8 did not express the naturally occurring, more abundant exon 7 deletion transcript. Most of the tumors expressed exon 2, exons 2-3, and exon 5 deletion variant transcripts. Unexpectedly, 2 of the 6 immunohistochemically ER- tumors showed full-length wild-type receptor mRNA but none of the variant transcripts.