Survival differences by race most apparent in advanced stages of breast cancer

Aug 13, 2007

Racial differences in breast cancer survival increase according to stage of disease, a new study finds. Published in the September 15, 2007 issue of CANCER, a peer-reviewed journal of the American Cancer Society, a retrospective analysis of survival data demonstrates that within each stage, African American women had larger tumors and were more likely to have disease that had spread to nearby lymph nodes.

After controlling for those clinical factors the racial disparities in survival persisted. The investigators say their finding that disparities in survival increased with more advanced disease was surprising and suggested that non-clinical factors contributed to survival differences.

Epidemiology studies have long showed significant racial/ethnic differences in breast cancer survival among U.S. women. African American women have poorer five-year survival rates, and more advanced disease at the time of diagnosis than white women. Whether these disparities are due to a difference between races in tumor biology or to socioeconomic factors that impact healthcare access and/or the physician-patient relationship continues to be unclear.

One key piece of evidence is that, stage for stage, African American women have worse clinical outcomes than white women. However, staging disease is complex, taking into account tumor size and regional or distant disease spread. Also, there can be significant differences in survival within each stage. For example, survival at the same stage can vary by 40 percent depending on the number of lymph nodes with disease.

Dr. Alfred Neugut from Columbia University Medical Center, Russell McBride from Mailman School of Public Health and their colleagues hypothesized that racial differences in survival within stage could be attributed to differences in tumor size and the number of lymph nodes with disease between the two race groups.

Analysis of clinical and demographic characteristics from 256,174 women with breast cancer (21,861 African American and 234,313 white) diagnosed from 1988-2003 showed that African American women were more likely than white women to be diagnosed with tumors greater than 2.0-cm and to have at least one lymph node with disease. However, racial differences in lymph node involvement were apparent only in tumors smaller than 3.0 cm.

After adjusting for tumor size and lymph node status as well as other known factors, such as age, African American women were still more likely to die from their disease. The mortality rate among African American women was calculated to be up to 56 percent higher than whites.

This study confirms “statistically significant differences within stage between black and white women in tumor size and nodal involvement.” However, the authors conclude, “these differences are not clinically important with respect to survival over and above the standard AJCC stage categories.”

The study also found that as stage of disease at diagnosis increases, so too does the gap in mortality between African American and white women. The authors postulate that “the factors that prevent black women from receiving the same quality of care as white women may be exacerbated by the more complex treatment regimens used for more advanced breast cancer.”

Source: John Wiley & Sons

Explore further: Phase 3 study may be game-changer for acute myeloid leukemia

add to favorites email to friend print save as pdf

Related Stories

Lifestyle determines gut microbes

Apr 15, 2014

An international team of researchers has for the first time deciphered the intestinal bacteria of present-day hunter-gatherers.

Researchers create embryonic stem cells without embryo

Jan 29, 2014

(Phys.org) —Since the discovery of human embryonic stem cells, scientists have had high hopes for their use in treating a wider variety of diseases because they are pluripotent, which means they are capable ...

Hookworm genome sequenced

Jan 19, 2014

Going barefoot in parts of Africa, Asia and South America contributes to hookworm infections, which afflict an estimated 700 million of the world's poor. The parasitic worm lives in the soil and enters the body through the ...

Recommended for you

Phase 3 study may be game-changer for acute myeloid leukemia

2 hours ago

Moffitt Cancer Center researchers say clinical trials for a new experimental drug to treat acute myeloid leukemia (AML) are very promising. Patients treated with CPX-351, a combination of the chemotherapeutic drugs cytarabine ...

User comments : 0

More news stories

FDA proposes first regulations for e-cigarettes

The federal government wants to prohibit sales of electronic cigarettes to minors and require approval for new products and health warning labels under regulations being proposed by the Food and Drug Administration.

Rising role seen for health education specialists

(HealthDay)—A health education specialist can help family practices implement quality improvement projects with limited additional financial resources, according to an article published in the March/April ...

When things get glassy, molecules go fractal

Colorful church windows, beads on a necklace and many of our favorite plastics share something in common—they all belong to a state of matter known as glasses. School children learn the difference between ...

FCC to propose pay-for-priority Internet standards

The Federal Communications Commission is set to propose new open Internet rules that would allow content companies to pay for faster delivery over the so-called "last mile" connection to people's homes.

SK Hynix posts Q1 surge in net profit

South Korea's SK Hynix Inc said Thursday its first-quarter net profit surged nearly 350 percent from the previous year on a spike in sales of PC memory chips.