AACR: Racial Disparities Observed in Breast Cancer

Blacks more likely to have poor outcomes, less likely to undergo lymph node assessment

FRIDAY, Nov. 30 (HealthDay News) -- Black women with breast cancer are more likely to have poorer outcomes, differences in gene expression profiles, and lower rates of lymph node assessment than their non-black counterparts, according to three studies presented at the American Association for Cancer Research conference on The Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved, held this week in Atlanta.

Michael A. Nichols, M.D., Ph.D., of the University of Chicago, and colleagues studied 1,246 women -- about one-third of them black -- who underwent lumpectomy and radiotherapy. Compared to non-blacks, they found blacks had lower rates of overall survival (78.1 percent versus 84.9 percent) and higher rates of relapse after eight years (31.6 percent versus 14.9 percent). They concluded that black women may benefit from frequent mammograms or the use of more sensitive screening methods, such as MRI.

Damali Martin, Ph.D., of the National Cancer Institute's Center for Cancer Research, and colleagues examined gene expression profiles in micro-dissected tumors from 35 patients (18 blacks and 17 whites) with invasive breast cancer. They identified racial differences -- most significantly in processes including angiogenesis, blood vessel development in the tumor stroma and the regulation of chemotaxis and antigen presentation/processing in the tumor epithelium -- that may influence disease aggressiveness and response to therapy.

Michael Halpern, M.D., Ph.D., of the American Cancer Society, and colleagues analyzed data from the National Cancer Database on 196,732 women who were treated for early-stage breast cancer. They found that blacks were 10 percent less likely than whites to receive lymph node assessment. They also found that the procedure was 24 percent less likely to be performed in uninsured versus insured women, 13 percent less likely to be performed in less educated versus highly educated women, and three times less likely to be performed in women ages 73 and older compared to women ages 51 and younger. "Disparity in receipt of this procedure among underserved populations is therefore a concern and requires further study," Halpern and his colleagues conclude.

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