The results are poorer for black patients with early breast cancer


Action Points

  • Note that this study was published as a summary and presented at a conference. These data and conclusions should be considered preliminary until they are published in a peer-reviewed journal.
  • Women with small early-stage bad cancers discovered by mammography have excellent results, but survival rates are significantly lower among black women compared to whites, according to a large federal database.
  • Note that initially the difference in survival was considered to be due to socioeconomic status and / or access to care, but recent data suggest that there may be a biological factor involved.

SAN ANTONIO – Women who have early-stage small bad cancer discovered on a mammogram have excellent survival, but rates are significantly lower among black women compared to white women, researchers at the annual Symposium San Antonio bad cancer.

disease-specific survival was 99% in white women compared to 94% in black women ( P <0.0001), said Mahvish Muzaffar, MD, of the University East Carolina , Greenville, North Carolina.

Overall 5-year survival was 93.7% among white women who were diagnosed with pT1aN0 or pT1bN0 tumors – generally less than 1 cm in diameter – but for black women with the same disease the overall survival was 91.5% ( P <0.0001).

"I think these findings should be very encouraging for all women who have these early and small cancers that are found with mammography," said Muzaffar MedPage Today . "But we still do not know why there is still a difference in the results by race."

"Very early bad cancer is badociated with an excellent result but it has some heterogeneity," he said in his poster presentation. Conventional prognostic factors are not enough to risk stratification of bad cancer very early and the molecular profile can help identify patients who will need adjuvant therapy. "

Muzaffar said" when we looked to see if there was a subset of patients that did not work well, highlighted. Whites and others like Asians did better than African Americans. The first thing we think is that the difference can be explained by the socioeconomic level and / or access to care, but lately we are seeing data that there may be a biological factor involved. We think the differences may have been that African Americans do not receive timely care and do not receive adequate care and may not have insurance and, therefore, receive suboptimal care. "

But Muzaffar said:" Other studies have explained These differences in care and, however, African-American women in those studies still had worse results. These factors can explain a large part of the difference, but they do not explain everything.

"While all these results are still very good, there are still differences," he said. "In this day and age, we must have equity."

"It is possible that the African-American population may have bad cancer that is a slightly more aggressive disease than that observed among non-black patients," said Muzaffar. What we probably need is to do studies focused on African Americans to try to discover what is driving this difference. "

Disparities by race also caught the attention of Jennifer Litton, MD, of MD Anderson Cancer Center at the University of Texas at Houston. "Even when we look at the results in clinical trials where everything is the same in terms of access to care, we still see discrepancies between the black and white results, and I think this just highlights the need to look for underlying factors," he said. .

"Fortunately, if we continue to look at patients' tumors, we can find some biological difference." Definitely there are discrepancies in pharmacodynamics. It means that we really need to continue researching because it is important to solve this, "he told MedPage Today.

To perform the test, Muzaffar and his colleagues agreed to the Federal Surveillance, Epidemiology and Final Results. Data (SEER) identified 50,796 women during the years 2006 and 2011 who had small bad cancer in early stage.The average age was 62 years, 85% were white and 7% African-American.

For the whole group, 5 years Disease-specific survival for women with estrogen receptor-positive cancer was 99% compared to 96% for women with estrogen receptor-negative initial stage cancer ( P ). < 0.0001), overall survival at 5 years was 94% for women with estrogen receptor positive cancer and 92% for women diagnosed with estrogen receptor negative disease ( P <0.0001).

About 72% of the women were diagnosed with bad cancer pT1bN0 36,347 people; 28% were bad cancer pT1aN0 or 14,449 individuals. Only 11% of women had negative estrogen receptors.

Muzaffar and Litton did not reveal any relevant relationship with the industry.

2017-08-12T00: 00: 00-0400

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