Differences in Disease Presentation, Management Techniques, Treatment Outcome, and Toxicities in African-American Women With Early Stage Breast Cancer Treated With Breast-Conserving Therapy

作者：Vicini Frank^*; Jones Pamela; Rivers Aeisha; Wallace Michelle; Mitchell Chris; Kestin Larry; Jaiyesimi Ishmael; Dekhne Nayana; Martinez Alvaro

来源：Cancer, 2010, 116(14): 3485-3492.

DOI：10.1002/cncr.25088

• African Americans
• racial disparities
• breast cancer
• radiation
• breast-conserving therapy

BACKGROUND: Data on patients who received breast-conserving therapy (BCT) for early stage breast cancer were examined to detect differences in disease presentation, management techniques, long-term treatment outcomes, and toxicities based on race. METHODS: Six hundred ninety-nine women with breast cancer (39 African-American [AA] women and 660 Caucasian [C] women) who received BCT were analyzed on race, clinical and pathologic characteristics at presentation, management techniques, treatment-related toxicities, recurrence, and survival. The median follow-up was 12.2 years. RESULTS: At diagnosis, AA women were younger (aged <50 years, 49% vs 29%; P = .002), had larger tumors (mean, 17.0 mm vs 13.9 mm; P = .032), had more estrogen receptor-negative tumors (56% vs 18%; P < .001), and higher nuclear grade tumors (grade 3, 52% vs 29%; P = .006). Compared with C women, AA women more frequently received adjuvant chemotherapy (59% vs 19%; P < .001) and lymph node irradiation (26% vs 13%; P = .033). No other significant treatment differences were observed. After treatment, AA women experienced more breast pain (P = .001), more arm edema (P = .046), and less excellent cosmetic results (P = .008), but there were no statistically significant differences in local recurrence (P = .232), distant metastasis (P = .263), overall survival (P = .131), or cause-specific survival (P = .092) based on race. CONCLUSIONS: The current results suggested that AA women present with larger and more aggressive breast tumors and, as a result, more frequently received adjuvant chemotherapy and lymph node irradiation. Small differences in treatment-related toxicities and cosmesis were observed, but no differences in efficacy were identified. Cancer 2010;116:3485-92.

• 出版日期2010-7-15