Utilization of Lymph Node Dissection, Race/Ethnicity, and Breast Cancer Outcomes

作者：Nurgalieva Zhannat Z^*; Franzini Luisa; Morgan Robert O; Vernon Sally W; Du Xianglin L

来源：American Journal of Managed Care, 2013, 19(10): 805-810.

Objectives: Although large differences by race/ethnicity in breast cancer survival are well established, it is unknown whether disparities in nodal surgery utilization explain the racial/ethnic disparities in survival among women with micrometastasis and macrometastasis in sentinel lymph nodes (SLNs). %26lt;br%26gt;Study Design: Retrospective cohort study. %26lt;br%26gt;Methods: Women with breast cancer who underwent sentinel lymph node biopsy (SLNB) and who were found to have nodal metastases were identified from the Surveillance, Epidemiology, and End %26lt;br%26gt;Results database (1998-2005). Outcomes data were examined for patients who underwent SLNB alone versus SLNB with axillary lymph node dissection (ALND). Results: Proportions of patients receiving SLNB alone or receiving SLNB with a complete ALND were not statistically different among women of different racial/ethnic backgrounds (P = .8). Patients of African American descent or Hispanic origin had reduced overall survival, whereas patients of Hispanic origin had reduced disease-specific survival after adjusting for selected covariates. Adjusting for nodal surgery did not reduce racial/ethnic disparities in overall survival or disease-specific survival. %26lt;br%26gt;Conclusions: The disparities in survival among African American and Hispanic women with breast cancer are not explained by nodal surgery utilization among women with micrometastasis and macrometastasis in SLNs.

• 出版日期2013-10