Chemotherapy Before Surgery Can Reduce Recurrence Risk in Black Women

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While black women are just as likely to be diagnosed with breast cancer as white women, breast cancer in black women is typically more aggressive than breast cancer in white women. Compared to white women, breast cancer in black women tends to be:

  • diagnosed at a younger age
  • more advanced at diagnosis
  • more likely to come back (recurrence)
  • more likely to be fatal at an early age

A study suggests that treating even early-stage breast cancer in black women with chemotherapy before surgery can help reduce their risk of recurrence.

The research was published on Jan. 13, 2017 by the journal PLoS ONE. Read “Distinctions in Breast Tumor Recurrence Patterns Post-Therapy among Racially Distinct Populations.”

Doctors call treatments given before surgery neoadjuvant treatments. Treatments given after surgery are called adjuvant treatments.

To do the study, the researchers compared recurrence rates and patterns after specific treatments in 1,096 black women and 4,773 white women who were treated for breast cancer at Northside Hospital from 2005 to 2015 in Atlanta, Ga.

Overall, 49 black women and 166 white women had a recurrence.

The researchers then looked to see if specific factors were linked to a higher risk of recurrence.

Age:

  • Women younger than 35 when diagnosed with breast cancer were more likely to have a recurrence than older women.
  • 61% of women who had a recurrence were younger than 48.
  • About 51% of the black women were diagnosed younger than age 48, compared to only 35% of the white women.

Treatments after surgery:

  • Black women were more likely to have a recurrence after adjuvant radiation therapy than white women.
  • Black women were more likely to have a recurrence after adjuvant hormonal therapy than white women.
  • Black women were more likely to have a recurrence after any combination of adjuvant treatments than white women.

Treatments before surgery:

  • Black women treated with neoadjuvant chemotherapy were less likely to have a recurrence than white women.

Cancer stage:

  • Among women diagnosed with stage I breast cancer, black women were more likely to have a recurrence than white women.
  • Among women diagnosed with stage I or stage II breast cancer, black women were more likely to have a recurrence than white women.
  • Among women diagnosed with later-stage breast cancer, black women were no more likely to have a recurrence than white women.

"We found that, in general, African-American breast cancer patients exhibit increased likelihood for tumor recurrence…after receiving any combination of adjuvant therapy compared to European-American breast cancer patients," said Nikita Wright, first author of the study and a biology Ph.D. student at Georgia State University. "This higher incidence of tumor recurrence can contribute to a poorer prognosis. Interestingly, we found that neoadjuvant chemotherapy actually reversed these recurrence trends."

It’s not clear why black women have higher breast cancer recurrence rates than white women. This study suggests that treating even early-stage breast cancer in black women with chemotherapy before surgery may reduce this higher risk of recurrence. Still, more research is needed before this becomes the standard of care.

No matter your ethnicity, if you’ve been diagnosed with breast cancer, you and your doctors will put together a treatment plan that meets the needs of your unique situation and takes into account your overall medical condition and your personal style of making decisions.

If you’re not comfortable with the treatment plan your doctor recommends or want to see if another doctor recommends the same options, you may want to consider getting a second opinion from another doctor.

Many women diagnosed with breast cancer feel a sense of urgency about jumping right in and starting treatment immediately. In most cases, though, there’s time to do some research to make sure your diagnosis is correct and your treatment plan makes sense -- and this may include getting a second opinion.

Getting a second opinion means asking another breast cancer specialist, or a team of specialists, to review all of your medical reports and test results, give an opinion about your diagnosis, and suggest treatment options. A second opinion may confirm your original doctor’s diagnosis and treatment plan, provide more details about the type and stage of breast cancer, raise additional treatment options you hadn’t considered, or recommend a different course of action. Even if you’ve already had treatment, it’s not too late to get a second opinion. A second doctor can weigh in on your diagnosis and treatment plan to date, offering any additional thoughts or recommendations.

No matter your age or ethnicity, you absolutely deserve the best medical care possible. Don’t be afraid to ask questions and advocate for your care.

Get more information on planning your treatment and getting a second opinion.



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