African American women with breast cancer less likely to have newer, recommended surgical procedure
African American women with early stage, invasive breast cancer were 12 percent less likely than Caucasian women with the same diagnosis to receive a minimally invasive technique, axillary sentinel lymph node (SLN) biopsy, years after the procedure had become the standard of surgical practice, according to research from The University of Texas MD Anderson Cancer Center.
The study, presented at the 2012 CTRC-AACR San Antonio Breast Cancer Symposium, also found that those African American women who underwent the older, more invasive procedure, axillary lymph node (ALN) dissection, had higher rates of lymphedema. The findings were presented today by Dalliah Mashon Black, M.D., assistant professor in MD Anderson's Department of Surgical Oncology.
SLN biopsy became accepted as standard of care for the staging of breast cancer in 2002 and the preferred practice by 2007 when the National Comprehensive Cancer Network and other national organizations endorsed the minimally-invasive procedure. The older technique, ALN dissection, is associated with a number of complications, including lymphedema. Black estimates that approximately 75 percent of newly diagnosed breast cancer patients are eligible for SLN biopsy.
"With this research, we wanted to determine if new surgical innovations were being incorporated fairly amongst different patient populations," says Black, also the study's first author. "This study looks at trends over time, comparing appropriate patients who all would have been candidates for the SLN biopsy to see how the new procedure was implemented in African Americans and Caucasians."
This video is not supported by your browser at this time.
This audio file reports findings that African American women are less likely to receive improved surgical procedure for breast cancer. Credit: MD AndersonFor the retrospective population-based study, the MD Anderson team used Medicare claims data between 2002 and 2007 from the Surveillance, Epidemiology and End Results (SEER) database to examine the surgical history of 31,274 women age 66 and older diagnosed with early-stage, invasive breast cancer. Of those women, 1,767 (5 percent) were African American, 27,856 (89 percent) were Caucasian and 1,651 (5.3 percent) were other, or of unknown race.
The researchers found that 62 percent of African American patients underwent the SLN biopsy, compared to 74 percent of the Caucasian patients. Although the SLN biopsy rate increased in both groups between 2002 and 2007, a fixed disparity persisted through the five years.
The five-year cumulative incidence of lymphedema was 12.1 percent in those who received ALN dissection, compared to 6.9 percent in those who received SLN biopsy. Overall, African Americans had a higher rate of the complication; however, among those patients who had the SLN biopsy, patients had similar risk of lymphedema, regardless of race.
"The risk of lymphedema was primarily driven by differences in treatment: ALN dissection resulted in about twice the risk. When we looked at outcomes stratified by treatment, Caucasians and African Americans had similar risks of lymphedema if they had a SLN," says Benjamin Smith, M.D., assistant professor in MD Anderson's Department of Radiation Oncology and the study's senior author. "This ties the treatment disparity to a disparity in outcome."
Overall, the findings were a surprise to Black and her team.
"We were surprised to learn that the disparity persisted through 2007 and that there was an adverse patient outcome, lymphedema, associated with the findings. However, when we controlled for tumor characteristics and types of breast surgery, there was still a significant difference," says Black.
"SLN is now a safe and integral part of the surgical management of early invasive breast cancer. Improving patient education and creating ways to ensure all healthcare providers know practice guidelines which they are able to implement, will help with this disparity. No early stage, appropriate patient should opt for less if properly educated," Black continues.
Provided by University of Texas M. D. Anderson Cancer Center
- Researchers find new, noninvasive way to identify lymph node metastasis Jan 12, 2012 | not rated yet | 0
- Breast cancer patients with positive ultrasound guided axillary node biopsy need dissection May 03, 2012 | not rated yet | 0
- Sentinel node biopsy safe for vulvar squamous cell cancer Jul 08, 2012 | not rated yet | 0
- Limited lymph node removal for certain breast cancer does not appear to result in poorer survival Feb 08, 2011 | not rated yet | 0
- Breast cancer returns more often in black women Oct 29, 2007 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
How can there be a term called "intestinal metaplasia" of stomach
23 hours ago Hello everyone, Ok Stomach's normal epithelium is simple columnar, now in intestinal type of adenocarcinoma of stomach it undergoes "intestinal...
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
Ratio of Hydrogen of Oxygen in Dessicated Animal Protein
May 13, 2013 As an experiment, for the past few months I've been consuming at least one portion of Jell-O or unflavored Knox gelatin per day. I'm 64, in very...
Alcohol and acetaminophen
May 13, 2013 Edit: sorry for the typo in the title , can't edit I looked around on google quite a bit and it's very hard to find precise information on the...
- More from Physics Forums - Medical Sciences
More news stories
The gap between life expectancy in patients with a mental illness and the general population has widened since 1985 and efforts to reduce this gap should focus on improving physical health, suggest researchers in a paper ...
Cancer 11 hours ago | not rated yet | 0
By studying the roles two proteins, thrombospondin-1 and prosaposin, play in discouraging cancer metastasis, a trans-Atlantic research team has identified a five-amino acid fragment of prosaposin that significantly reduces ...
Cancer 12 hours ago | not rated yet | 0
A novel transcriptome-based classification of colon cancer that improves the current disease stratification based on clinicopathological variables and common DNA markers is presented in a study published in PLOS Medicine this w ...
Cancer 13 hours ago | not rated yet | 0
A study of veterans at high risk for developing lung cancer shows that low-dose computed tomography (LDCT) can be highly effective in helping clinicians spot tiny lung nodules which, in a small number of patients, may indicate ...
Cancer 14 hours ago | not rated yet | 0
An attack on glioblastoma brain tumor cells that uses a modified poliovirus is showing encouraging results in an early study to establish the proper dose level, researchers at Duke Cancer Institute report.
Cancer 16 hours ago | not rated yet | 0
Is it permissible to harm one to save many? Those who tend to say "yes" when faced with this classic dilemma are likely to be deficient in a specific kind of empathy, according to a report published in the scientific journal ...
1 hour ago | not rated yet | 0 |
Phthalates: Study links chemicals widely found in plastics, processed food to elevated blood pressure in children, teens
Plastic additives known as phthalates (pronounced THAL-ates) are odorless, colorless and just about everywhere: They turn up in flooring, plastic cups, beach balls, plastic wrap, intravenous tubing and—according to the ...
2 hours ago | not rated yet | 1 |
(Medical Xpress)—Native peoples in regions where cameras are uncommon sometimes react with caution when their picture is taken. The fear that something must have been stolen from them to create the photo ...
18 hours ago | 4.2 / 5 (5) | 0 |
(Medical Xpress)—Despite spending billions of dollars on research and development, drug companies have been unable to come up with effective treatments for dementia and Alzheimer's Disease (AD). Now, A. ...
16 hours ago | 4.9 / 5 (14) | 0 |
Australian scientists have charted the path of insulin action in cells in precise detail like never before. This provides a comprehensive blueprint for understanding what goes wrong in diabetes.
18 hours ago | 4.6 / 5 (7) | 0 |
Activating an enzyme known to play a role in the anti-aging benefits of calorie restriction delays the loss of brain cells and preserves cognitive function in mice, according to a study published in the May ...
13 hours ago | 5 / 5 (5) | 0 |