Recurrence After Lumpectomy Higher in African American Woman Than Whites

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A study looked at the risk of early breast cancer coming back (recurrence) after lumpectomy (breast-conserving surgery) and whole breast radiation in African American women and white women.

About 2,400 women were followed 5 to 10 years after surgery (7 years follow-up was the average). Overall, African American women were more likely than white women to have the cancer come back. Five years after surgery, 13% of African American women and 7% of white women had had the breast cancer come back. Ten years after surgery, 17% of African American women and 13% of white women had had the cancer come back.

No matter your race or ethnic background, if you've been diagnosed with early breast cancer and surgery is part of your treatment plan, you and your doctor will talk about the type of surgery that is best for you. There are 2 main options:

  • Lumpectomy (breast-conserving surgery), which removes the tumor and some of the normal tissue that surrounds it. Lumpectomy is usually followed by radiation therapy to the remaining breast tissue.
  • Mastectomy, which removes the whole breast. Radiation is sometimes given after mastectomy.

Research shows that lumpectomy followed by radiation is equally as effective as mastectomy for women with:

  • cancer in only one place in the breast
    and
  • a cancer smaller than 4 centimeters with no cancer cells found in the tissue surrounding the tumor (clear margins)

Your doctor also will consider how aggressive the cancer is and your individual risk of the cancer coming back. Together, all these factors will help you and your doctor decide which type of surgery is best for you.

Breast cancer in African American women is typically more aggressive than breast cancer in white women. Compared to white women, breast cancer in African American women tends to be:

  • diagnosed at a younger age
  • more advanced at diagnosis
  • more likely to be fatal at an earlier age
  • more likely to be triple negative (estrogen- receptor-negative, progesterone- receptor-negative, and HER2-negative)

Treatment options such as hormonal therapy and Herceptin aren't effective for triple-negative breast cancer.

Since breast cancer tends to be more aggressive in African American women, it makes sense to study whether lumpectomy and whole breast radiation really is a good treatment option. Although the African American women in this study did have a higher risk of the cancer coming back compared to white women, the difference was small. So the researchers felt that lumpectomy followed by whole breast radiation was still a good option for African American women diagnosed with early breast cancer.

If you're an African American woman making decisions about breast cancer surgery, talk to your doctor about the results of this research. Together you can make the choice that is best for YOU.

You can learn more about surgery options for early breast cancer in the breastcancer.org Surgery section.

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