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4 September 2008
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US racial disparities identified in radiation treatment after breast surgery
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MedWire News: Black women with breast cancer in the USA are less likely to receive radiation therapy after breast conserving surgery, called lumpectomy, than their White counterparts, research shows.
"The use of radiation after lumpectomy is considered to be the standard of care for women with invasive breast cancer, as clinical trials have demonstrated that it both reduces the chance of recurrence and improves the chance of survival," said researcher Dr Thomas Buchholz, from the University of Texas MD Anderson Cancer Center in Houston, USA.
However, although a number of relatively small studies have been conducted into racial disparities in breast cancer care in the USA, no previous research has examined differences across the nation, say the researchers.
To address this, the team led by Dr Grace Li Smith, also from the MD Anderson Cancer Center, used the national Medicare database to identify all patients aged 66 years and older who were diagnosed with early-stage breast cancer in 2003.
Out of the 37,305 women who underwent a lumpectomy for their breast cancer, 34,024 were White and 2305 were Black.
The researchers found that, overall, 74% of the White women received radiation therapy after lumpectomy, compared with just 65% of the Black breast cancer patients.
However, the magnitude of the racial disparities in treatment differed across the country. For example, 72% of White lumpectomy patients in the Pacific West received radiation therapy after lumpectomy compared with just 55% of Black lumpectomy patients, while in the North Central Midwest there was virtually no discrepancy, with 74% of White and 72% of Black women receiving radiation therapy after lumpectomy.
Commenting on the findings, Dr Smith said: "Until further research is conducted, we may only speculate about the underlying reasons why Black and White women are not receiving radiation at the same rate.
"We don't know if fewer Black women are receiving radiation simply because it is not offered to them, because they decline the treatment, or perhaps because they are unable to complete a whole course of treatment due to other health problems.
"These questions will be important subjects of future study."
She added: "As a medical community, we need to identify and eliminate any obstacle prohibiting all women from receiving necessary care for their breast cancer."
The findings will be presented at the American Society of Clinical Oncology Breast Cancer Symposium in Washington DC, USA.
American Society of Clinical Oncology Breast Cancer Symposium; Washington DC, USA: 5-7 September 2008
http://www.asco.org/ASCO/Meetings/ASCO+Symposia+%26+Workshops/The+Breast+Cancer+Symposium/2008+Breast+Cancer+Symposium
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