Characteristics and treatment modalities for African American women diagnosed with stage III breast cancer

Abstract

BACKGROUND: Stage III breast cancers account for about 6% to 7% of all invasive breast cancers diagnosed annually in the United States. In African American (AA) women, the incidence of stage III breast cancers is almost double that in Caucasian women. The aim of this study was to correlate age, receptor status, nuclear grade, and differences in treatment modalities for stage III breast cancer in an inner‐city hospital serving a large AA population. METHODS: A retrospective review was performed for all stage III primary breast cancers diagnosed and or treated from 2000 to 2006. RESULTS: Of 840 primary invasive breast cancers, the authors identified 107 as stage III, 40.2% IIIA, 32.7% IIIB, 16.8% T4D, and 10.3% IIIC. The majority of the patients were AA (n = 93, 86.9%). Stage IIIC patients were younger (P < .05). Triple negative tumors (TNT) accounted for 29.0%. TNT were more likely among the inflammatory breast cancers (50.0%) compared with the other 3 groups (P < .05). Twenty‐two patients (20.5%) refused chemotherapy, and 24 of the 91 patients (26.3%) who should have received chest wall radiation refused. There was no difference in race, marital status, religion, or age in the patients that refused chemotherapy or radiation therapy versus the majority of patients in this series who received standard care. CONCLUSIONS: Stage III breast cancers in AA women have distinct clinical characteristics. A high number of these patients refused chemotherapy and radiation therapy. Reasons for refusal need to be better defined so strategies can be implemented to improve compliance for these advanced stage patients. Cancer 2009. © 2009 American Cancer Society.

Disparities in race/ethnicity and socioeconomic status: risk of mortality of breast cancer patients in the California Cancer Registry, 2000–2010

“…Although it has been suggested that suboptimal use of adjuvant treatments may explain differences in outcomes, [9,42-46] others have reported little or no differences between black and white patients with regard to chemotherapy administration [73-75]. Differences in adjuvant treatment between black and white women may explain the disparities we noted in stages 2 and 3 [76,77]. However, since the disparities occurred only in the two highest SES categories, we can speculate that patients of all race/ethnicities should have had equal access to adjuvant treatment.…”

Narrowing racial gaps in breast cancer chemotherapy initiation: the role of the patient–provider relationship

“…Clinical factors that were used to control for chemotherapy outcomes included estrogen receptor (ER) status (positive vs. negative), surgery type (lumpectomy or mastectomy), nodal status (positive or negative), pathological tumor size, and human epidermal growth factor receptor (Her2/neu), which was categorized similar to other reports as positive, negative, or unknown [39]. Comorbidity was measured using the Charlson comorbidity index score [40].…”

Patterns of Utilization of Adjuvant Radiotherapy and Outcomes in Black Women After Breast Conservation at a Large Multidisciplinary Cancer Center

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