The study reviewed here 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:
Research shows that lumpectomy followed by radiation is equally as effective as mastectomy for women with:
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:
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.
LOS ANGELES (Reuters Health) - Ten years after breast-conserving therapy, the breast cancer recurrence rates are higher among African American women than among Caucasian women, researchers reported here at the annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO). However, the difference is not great, so breast-conserving therapy should remain an option for African American women.
Dr. Meena S. Moran of Yale University School of Medicine in New Haven, Connecticut, and colleagues studied 2,382 women with breast cancer treated between 1975 and 2003 with conservative surgery followed by whole breast radiation, with or without regional lymph node radiation and adjuvant chemotherapy. Of the total, 218 were African American women with equal access to healthcare.
Conservative surgery for breast cancer, also referred to as "lumpectomy," a treatment option for some early-stage cancers, involves removal of the cancerous tumor, along with a border of healthy tissue surrounding it to insure that all of the cancer is removed.
The average follow-up period was 7 years. Breast cancer relapse after 5 years occurred in 13 percent of black and 7 percent of white women, Moran reported. At 10 years, the relapse rates were 17 percent and 13 percent for blacks and whites, respectively.
Features of the disease also differed markedly between the races, Moran continued. The percentage of black women who were younger than 40 years at diagnosis was 19.7 percent compared with 12.2 percent for white women. More black women had tumor stage T2 than white women, at 29 percent and 15 percent, respectively. (Tumor stage refers to the size and extent of the primary tumor and is rated from (T0 to T4.)
Breast cancer spread to the lymph nodes was detected in 32 percent of black and 24 percent of white women.
"Triple negative" disease was present in 35 percent of African American and 22 percent of Caucasian women. In triple-negative breast cancers, the cancer cells lack the receptors for estrogen, progesterone, and human epidermal growth factor receptor 2 (HER2) and therefore cannot be controlled with drugs, such as tamoxifen, which target these receptors, limiting treatment options.
Estrogen receptor-negative disease was present in 54 percent of black and 36 percent of white women.
Nearly one third (32 percent) of black women were positive for the tumor marker p53, indicating more aggressive disease, compared with 13 percent of Caucasian women.
After 10 years, distant spread, or "metastases," had occurred in 17 percent of African American and 13 percent of Caucasian women. Lymph node recurrence was seen in 6 percent of black women and 2 percent of white women, Moran reported.
An objective of the study was to assess how appropriate breast-conserving surgery is in African American women, given the more aggressive nature of their disease than in Caucasian women, she commented during her presentation at ASTRO.
"Although African American women have statistically significantly higher recurrence rates in breast and lymph nodes...the magnitude of the difference -- 17 percent versus 13 percent -- is still relatively small, suggesting that breast-conserving treatment remains an excellent treatment option for African American women wishing to conserve their breasts," Moran concluded.
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