More whites than blacks get breast cancer chemo
NEW YORK (Reuters Health) - For many different reasons, African American women do not receive add-on therapy after breast cancer as often as white American women do, a new study shows.
"Some of it has to do with socioeconomics, some with insurance status and/or access to care, but there are choice issues as well, especially with chemotherapy," study leader Dr. Mousumi Banerjee, noted in a statement from the University of Michigan School of Public Health.
In an attempt to disentangle the effects of race on breast cancer treatment, Banerjee and colleagues in Ann Arbor analyzed data on 651 African American and white American women diagnosed with breast cancer between 1990 and 1996.
Mirroring other studies, they found that African American women were more likely than white women to have more advanced-stage disease. African American women were also more likely than white women to be unmarried, have government insurance, live in poor neighborhoods and have more other illnesses, according to the report in the medical journal Cancer.
In analyses accounting for these factors, African American women with early-stage disease were just as likely as white women to undergo breast-sparing surgery rather than mastectomy, and to be treated with tamoxifen and adjuvant (i.e., add-on) chemotherapy.
However, among women with more advanced acncer, whites were nearly five times more likely to be given tamoxifen and more than three times more likely to receive chemotherapy.
The results also showed that women with early-stage breast cancer who had government-provided health insurance were less likely to undergo combined breast-conserving surgery and radiation and more likely to undergo mastectomy without radiation than women enrolled in non-governmental insurance plans or private insurance plans.
"The results from this study," Banerjee and colleagues conclude, "may be used to target educational interventions to improve the use of adjuvant therapies among African American women."
SOURCE: Cancer, online October 8, 2007.
What breastcancer.org says about this article…
More whites than blacks get breast cancer chemo
Research has shown that breast cancer in African American women is genetically different compared to breast cancer in white women. It's usually more aggressive, and diagnosed at an earlier age and at a more advanced stage.
The study reviewed here suggests that African American women are less likely than white women to get treatment aimed at bringing about the best possible outcome. This is troubling. The researchers found that a number of factors explained the differences in treatment, including social and financial circumstances such as a lack of insurance. The researchers also found that differences in treatment preferences probably explained some of the difference. This might mean that more African American women may choose not to have chemotherapy even though there are no other obstacles to that treatment.
If you're an African American woman diagnosed with breast cancer, you can't change the genetics of the cancer. But, together with your medical team, you can work toward getting the best possible treatment for your unique situation.
Try to make your decisions based on knowledge, not fear or uncertainty. Talk to your doctor about ALL the treatment options appropriate for your situation. Together, you can make informed decisions that are best for YOU.