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    More Return of Breast Cancer in Blacks

    But Breast-Conserving Surgery Still Reasonable Option for African-Americans
    By
    WebMD Health News
    Reviewed by Louise Chang, MD

    Oct. 29, 2007 (Los Angeles) -- Cancer is more likely to come back in the breasts of African-American women with early-stage breast cancer who undergo breast-conserving surgery than in their white counterparts, according to the largest study of its kind.

    But the difference in recurrence rates a decade after treatment -- 17% in African-Americans vs. 13% in whites -- is so small that breast-conserving therapy is a reasonable option for both, researchers say.

    "The findings should be discussed with African-American women, but the overall news is good," says Anthony Zeitman, MD, a cancer specialist at Harvard Medical School who was not involved with the work.

    "More than four in five African-American women with early-stage breast cancer will still have good results while preserving their breast," he tells WebMD.

    Zeitman led a news conference at the annual meeting of the American Society for Therapeutic Radiology and Oncology to discuss the findings.

    Many African-Americans Opt for Mastectomy

    For women with early-stage breast cancer, breast-conserving surgery -- a lumpectomy followed by radiation therapy to kill any remaining cancer cells -- is an accepted treatment.

    "But many African-American women are going straight to mastectomy due to their more aggressive disease," researcher Meena S. Moran, MD, a radiation oncologist at the Yale University School of Medicine in New Haven, Conn., tells WebMD.

    "All women should talk to their doctors about breast-conserving surgery," she says.

    Moran and colleagues studied 2,382 women with early-stage breast cancer who underwent breast-conserving surgery; 207 of them were African-American.

    Blacks Have More Aggressive Breast Tumors

    The findings also confirm recent reports that African-American women are more likely to have aggressive tumors than white women and that biology, not socioeconomic factors such as access to care, are to blame, Moran says.

    Among the findings:

    • African-Americans are more likely to have tumors that are not fueled by estrogen or progesterone than white women.
    • Tumors that are not fueled by estrogen or progesterone are associated with a less favorable prognosis than those that are fueled by the hormones.
    • Twenty percent of African-Americans were 40 or younger at diagnosis vs. 12% of whites.
    • Thirty-two percent of African-American women had tumors that were greater than 2 centimeters in diameter vs. 18% of white women.
    • African-Americans were more likely to have cancer that had spread to the lymph nodes: 32% vs. 24% of whites.
    • Women of both races were equally likely to have their tumors detected by mammography.
    • During surgery, the tumor was equally likely to be completely taken out in African-Americans and whites.

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