African-American women with invasive breast cancer less likely to receive invasive technical

African-American women with invasive breast cancer less likely to receive invasive technical -

African-American women with early stage invasive breast cancer was 12 percent less likely than white women with the same diagnosis to receive a minimally invasive technique, axillary sentinel lymph node (SLN), even though the procedure had become the surgical standard of practice, according to a study of University of Texas MD Anderson Cancer Center.

study, first presented at the Symposium on Breast Cancer in 2012 CTRC-AACR San Antonio and now updated and published in JAMA Surgery , also found that African women -américaines who have undergone the procedure older, more invasive axillary lymph node (ALN) dissection had higher rates of lymphedema. The results were presented today by Dalliah Mashon Black, MD, assistant professor in the Department of Surgical Oncology at MD Anderson.

SLN biopsy has become the preferred practice for breast cancer staging in 02 and the standard of care in 07, when the National Comprehensive Cancer Network and other national organizations approved minimally invasive procedure . The oldest technique, dissection RLA is associated with a number of complications, including lymphedema. Black estimates that about 75 percent of patients with newly diagnosed breast cancer are eligible for SLN biopsy.

"With this research, we wanted to determine whether new surgical innovations were incorporated equally among the different patient populations," said Black, also the first author of the study. "This study examine trends over time by comparing all appropriate patients who were candidates for SLN biopsy to see how the new procedure was implemented in African-Americans and Caucasians. "

For the retrospective study based on population, the MD Anderson team used Medicare claims data between 02 and 07 surveillance, Epidemiology and End Results Database (SEER) to examine the 31.274 surgical history of women 66 and older diagnosed with early stage invasive breast cancer. Among women, 1767 (5 percent) were African American, 27 856 (89 percent) were white and 1651 (5.3 percent) were the other or unknown race.

The researchers found that 62 percent of African-American patients underwent SLN biopsy, compared with 74 percent of white patients. Although the SLN biopsy rate increased in both groups between 02 and 07, a fixed disparity persisted through five years.

The cumulative incidence of lymphedema five years was 12.2 percent among those who received ALN dissection, compared with 6.8 percent among those who received SLN biopsy. Overall, African Americans had a complication rate with 18 per cent having higher lymphedema after axillary dissection; However, among patients who underwent SLN biopsy, patients had the same risk of lymphedema, regardless of race

"lymphedema risk is primarily attributable to differences in treatment :. RLA dissection leads to approximately twice the risk. When we reviewed the stratified results by the treatment, Caucasians and African Americans had similar risks of lymphedema if they had a SLN "said Benjamin Smith, MD, associate professor in the Department of MD Anderson Radiation Oncology and author main study. "This binds the disparate treatment to a disparity in the results."

Overall, the results were a surprise to Black and his team.

"We were surprised to learn that the disparity persists until 07 and there was a result to the adverse patient lymphedema associated with the results. However, when we checked characteristics the tumor and the types of breast surgery, there was still a significant difference, "said black.

" SLN is a safe and integral part of the surgical management of early invasive breast cancer. improving patient education and creating ways to ensure that all health care providers are aware of the practice guidelines and are able to implement them contribute to this disparity. Suitable patients with breast cancer at the early stage should not opt ​​for less of this standard in care if properly educated, "says Black.