Historically, research shows minority women, particularly blacks and Hispanics, are less likely than white women to obtain radiation treatment for their aggressive breast cancer.
Now a new study confirms the findings of previous studies showing that differences in treatment can contribute to poorer breast cancer outcomes for racial and ethnic women.
Prior research has shown that non-Hispanic black women have lower breast cancer survival rates relative to other racial and ethnic groups and researchers wanted to know why.
Differences in which treatment a woman receives is a significant factor to better or poorer breast cancer outcomes, but it may be only part of a broader explanation, said Abigail Silva, M.P.H. Silva is a Susan G. Komen Cancer Disparities Research trainee at the University of Illinois in Chicago.
Silva said that although radiation treatment decreases the risk for breast cancer recurrence and improves survival from the disease, minority women with aggressive breast tumors were more likely to receive chemotherapy instead.
Silva presented the new study results at the Fifth American Association For Cancer Research (AACR) Conference on The Science of Cancer Health Disparities, held in San Diego, CA Oct. 27-30, 2012.
Data from a population-based study of 397 non-Hispanic whites, 411 non-Hispanic blacks and 181 Hispanics patients with single invasive primary tumors indicated that minority women were less likely to start radiation treatment compared with non-Hispanic white women after breast conserving surgery .
The study showed only 79 percent of study participants eligible for radiation treatment actually got it.
Minority women were more likely to have aggressive (moderate-to high-grade) tumors and symptoms of breast cancer , such as a lump, a spontaneous clear or bloody discharge from the nipple or a change in appearance of the breast.
As a result, these women were more likely to undergo chemotherapy at the expense of beginning and completing radiation therapy.
Given these results, Sliva and colleagues believe clinicians might not be recommending radiation treatment to all eligible patients, consistent with national cancer treatment guidelines and its disproportionately affecting minority patients, according to the study.
“We found that patients who got chemotherapy were less likely to get radiation when they needed it,” Silva said. “However, once a treatment recommendation was made, the vast majority of patients received that treatment.”
Adjuvant radiation therapy is delivered after a cancer is treated with a primary therapy, usually surgery.
Primary therapy is used to remove the cancerous growth or reduce the tumor size. Adjuvant therapy follows to destroy any remaining cancer cells as a sort of insurance policy to prevent the cancer from recurring in the same organ or spreading to neighboring tissues.
When radiation is used as adjuvant therapy, it has the ability to kill otherwise potent cancer cells that primary therapy might have left untouched.
For some cancers, such as breast and prostate, adjuvant radiation therapy can be used as a primary treatment in place of surgery, depending on the type of tumor, its size and grade.
The researchers recommend clinicians not only more closely follow the treatment guidelines, but should also examine individual tumors on a molecular level to improve a patient’s cancer care.
They believe this could reduce the overuse of chemotherapy, and may also eliminate chemotherapy as a potential barrier to eligible patients receiving radiation therapy.
In the next phase of their research, Silva and colleagues plan to examine the role of mutable patient factors such as social support, cultural beliefs and provider mistrust, which may help further explain the disparity in initiation of radiation treatment.
The National Cancer Institute booklet, What You Need To Know About Breast Cancer, is available online
in English and En español.
Lynette Summerill is an award-winning writer and Scuba enthusiast who lives in San Diego with her husband and two beach loving dogs. Besides writing about cancer-related issues for EmpowHER, her work has been seen in newspapers and magazines around the world.
Sources:
“Mediators of Racial/Ethnic Disparities in Radiation Treatment among Breast Cancer Patients.” Abigail Silva(1), Garth H. Rauscher(1), Rao D. Ruta(2), Kent Hoskins(3). (1)University of Illinois School of Public Health, Division of Epidemiology and Biostatistics, Chicago, IL, (2)Rush University Medical Center, Chicago, IL, (3)University of Illinois College of Medicine, Chicago, IL. Paper Presented at 5th AACR Conference on The Science of Cancer Health Disparities, Oct. 28, 2012.
“Survival difference between non-Hispanic black and non-Hispanic white women with localized breast cancer: the impact of guideline-concordant therapy.” Wu X, Richardson LC, Kahn AR, Fulton JP, Cress RD, Shen T, Wolf HJ, Bolick-Aldrich S, Chen VW. J Natl Med Assoc. 2008 May; 100(5):490-8. Access online at:
http://www.ncbi.nlm.nih.gov/pubmed/18507201
Reviewed October 30, 2012
by Michele Blacksberg RN
Edited by Jody Smith