Black women less likely than white women to receive follow-up treatments after breast cancer surgery

Sep 5 2008

Black women who undergo a lumpectomy surgery to treat early-stage breast cancer are less likely than their white counterparts to receive the recommended follow-up radiation therapy treatments, according to study released on Wednesday, Reuters/Boston Globe reports. Standard care after a lumpectomy includes a series of radiation treatments to ensure that all cancerous cells have been treated.

The study, led by Grace Li Smith, a postdoctoral fellow in radiation oncology at the University of Texas M.D. Anderson Cancer Center, looked at 37,305 women ages 65 and older who had undergone lumpectomy surgery to remove cancerous tumors from their breasts. Of the women, 34,024 were white and 2,305 were black. Researchers found that 65% of black women received radiation therapy after the surgery, compared with 74% of white women. The disparities were more prevalent on the West Coast, in the South and the Northeast, while certain regions -- including the West and Midwest -- showed no racial disparities, according to the study (Dunham, Reuters/Boston Globe, 9/3).

The study did not look at the reasons for the findings, but Smith noted that possible reasons black women are not receiving follow-up treatment include doctors not offering them the treatment, black women declining the treatment or being unable to complete the entire treatment series because of other health problems. The study looked at Medicare beneficiaries, of whom all had insurance coverage for lumpectomy and radiation, so access to care was not a significant factor, the Chronicle reports.

David Wetter, chair of M.D. Anderson's Health Disparities Research department, said, "Physicians have a lot of unconscious biases about who's likely to comply with or accept treatment, and some patient populations are more likely to be suspicious of radiation's effectiveness or side effects."

Eric Winer, a Harvard University professor of medicine and director of the Dana-Farber Cancer Institute's Breast Oncology Center, said, "When women have the two-step treatment of lumpectomy and radiation, it's possible for some to fall through the cracks," but "there's absolutely no reason it should be happening more frequently to black women." Wetter added, "It's clear that there's a whole lot going on in clinical encounters that needs to be examined more."

The study will be presented on Friday at the Second Annual American Society of Clinical Oncology Breast Cancer Symposium (Ackerman, Houston Chronicle, 9/3).