Source: DGNews  |  Posted 4 years ago

By Ed Susman

LOS ANGELES, CA -- October 30, 2007 -- African American women who opt for breast conserving surgery for early stage breast cancer have significantly higher recurrence rates for nodal and breast recurrence.

"We found that about 17% of the African American women experience a recurrence in the treated breast compared to 13% of Caucasian women who undergo lumpectomy instead of mastectomy," said Meena Moran, MD, Assistant Professor of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut, United States.

That difference reached statistical significance at the P =.045 level, Dr. Moran said in a presentation on October 29 at the 49th Annual Meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO).

Dr. Moran said that 6% of African American women experienced recurrence in the lymph nodes compared with 2% of Caucasian women (P =.006). The study included 2,382 women treated at Yale over a 30-year period. The analysis scrutinised outcomes in the women after 10 years post-treatment.

The reasons for the differences between the two populations were difficult to tease out, she said. Despite the differences in recurrence, there was no difference in overall survival. "We also need to point out that more than 80% of African American women who underwent breast conserving therapy have not had any recurrences," she added.

The analysis revealed no differences in treatment between the two groups, Dr. Moran said, but did find a number of significant differences in the biology of the breast cancers:

· About 54% of African American women were oestrogen receptor negative compared with 36% of Caucasian women (P =.0001).

· About 58% of African American women were progesterone receptor negative compared with 47% of Caucasian women (P =.0007)

· About 27% of African American women were HER2 negative compared with 28% of Caucasian women (P = NS).

· About 21% of African American women were "triple-negative" -- negative for oestrogen, progesterone and HER2 -- compared with 8% of Caucasian women (P <.0001)

· About 32% of African American women were p53 positive compared with 13% of Caucasian women (P =.0003).

Dr. Moran said that women who are "triple-negative" are often considered to have a worse prognosis, but that is mainly due to the fact that there are few drugs available for treating these women, while those with positive receptors can be treated with tamoxifen, aromatize inhibitors and specific biological agents, such as trastuzumab, that attack cancers which are HER2-positive.

"There is a biological difference between African American women and white women," Dr. Moran said.

She urged more research in the area and said that doctors should encourage African American women to enter well-designed clinical trials.

"This study confirms the aggressive nature of breast cancer in African-American women and emphasises how important it is for all African American women to see their healthcare providers regularly and to go for screening mammograms to try to catch any abnormalities early," she said.

For patients with early-stage breast cancer, the current standard treatment involves a lumpectomy, followed by radiation therapy to the breast over a 5- to 6-and-a-half-week period to kill any remaining cancer cells.

[Presentation title: Differences Between African American (AA) and Caucasian (C) Patients Treated With Conservative Surgery and Radiation Therapy (CS+RT) for Early Stage Breast Cancer. Plenary 8]