Differences in disease presentation, management techniques, treatment outcome, and toxicities in African-American women with early stage breast cancer treated with breast-conserving therapy

Frank Vicini, Pamela Jones, Aeisha Rivers, Michelle Wallace, Chris Mitchell, Larry Kestin, Ishmael Jaiyesimi, Nayana Dekhne, Alvaro Martinez

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

BACKGROUND: Data on patients who received breast-conserving therapy (BCT) for early stage breast cancer were examined to detect differences in disease presentation, management techniques, long-term treatment outcomes, and toxicities based on race. METHODS: Six hundred ninety-nine women with breast cancer (39 African-American [AA] women and 660 Caucasian [C] women) who received BCT were analyzed on race, clinical and pathologic characteristics at presentation, management techniques, treatment-related toxicities, recurrence, and survival. The median follow-up was 12.2 years. RESULTS: At diagnosis, AA women were younger (aged <50 years, 49% vs 29%; P = .002), had larger tumors (mean, 17.0 mm vs 13.9 mm; P = .032), had more estrogen receptor-negative tumors (56% vs 18%; P < .001), and higher nuclear grade tumors (grade 3, 52% vs 29%; P = .006). Compared with C women, AA women more frequently received adjuvant chemotherapy (59% vs 19%; P < .001) and lymph node irradiation (26% vs 13%; P = .033). No other significant treatment differences were observed. After treatment, AA women experienced more breast pain (P = .001), more arm edema (P = .046), and less excellent cosmetic results (P = .008), but there were no statistically significant differences in local recurrence (P = .232), distant metastasis (P = .263), overall survival (P = .131), or cause-specific survival (P = .092) based on race. CONCLUSIONS: The current results suggested that AA women present with larger and more aggressive breast tumors and, as a result, more frequently received adjuvant chemotherapy and lymph node irradiation. Small differences in treatment-related toxicities and cosmesis were observed, but no differences in efficacy were identified.

Original languageEnglish (US)
Pages (from-to)3485-3492
Number of pages8
JournalCancer
Volume116
Issue number14
DOIs
StatePublished - Jul 15 2010

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Disease Management
African Americans
Breast
Breast Neoplasms
Therapeutics
Adjuvant Chemotherapy
Survival
Lymph Nodes
Mastodynia
Recurrence
Neoplasms
Cosmetics
Estrogen Receptors
Edema
Arm
Neoplasm Metastasis

Keywords

  • African Americans
  • Breast cancer
  • Breast-conserving therapy
  • Racial disparities
  • Radiation

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Differences in disease presentation, management techniques, treatment outcome, and toxicities in African-American women with early stage breast cancer treated with breast-conserving therapy. / Vicini, Frank; Jones, Pamela; Rivers, Aeisha; Wallace, Michelle; Mitchell, Chris; Kestin, Larry; Jaiyesimi, Ishmael; Dekhne, Nayana; Martinez, Alvaro.

In: Cancer, Vol. 116, No. 14, 15.07.2010, p. 3485-3492.

Research output: Contribution to journalArticle

Vicini, Frank ; Jones, Pamela ; Rivers, Aeisha ; Wallace, Michelle ; Mitchell, Chris ; Kestin, Larry ; Jaiyesimi, Ishmael ; Dekhne, Nayana ; Martinez, Alvaro. / Differences in disease presentation, management techniques, treatment outcome, and toxicities in African-American women with early stage breast cancer treated with breast-conserving therapy. In: Cancer. 2010 ; Vol. 116, No. 14. pp. 3485-3492.
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abstract = "BACKGROUND: Data on patients who received breast-conserving therapy (BCT) for early stage breast cancer were examined to detect differences in disease presentation, management techniques, long-term treatment outcomes, and toxicities based on race. METHODS: Six hundred ninety-nine women with breast cancer (39 African-American [AA] women and 660 Caucasian [C] women) who received BCT were analyzed on race, clinical and pathologic characteristics at presentation, management techniques, treatment-related toxicities, recurrence, and survival. The median follow-up was 12.2 years. RESULTS: At diagnosis, AA women were younger (aged <50 years, 49{\%} vs 29{\%}; P = .002), had larger tumors (mean, 17.0 mm vs 13.9 mm; P = .032), had more estrogen receptor-negative tumors (56{\%} vs 18{\%}; P < .001), and higher nuclear grade tumors (grade 3, 52{\%} vs 29{\%}; P = .006). Compared with C women, AA women more frequently received adjuvant chemotherapy (59{\%} vs 19{\%}; P < .001) and lymph node irradiation (26{\%} vs 13{\%}; P = .033). No other significant treatment differences were observed. After treatment, AA women experienced more breast pain (P = .001), more arm edema (P = .046), and less excellent cosmetic results (P = .008), but there were no statistically significant differences in local recurrence (P = .232), distant metastasis (P = .263), overall survival (P = .131), or cause-specific survival (P = .092) based on race. CONCLUSIONS: The current results suggested that AA women present with larger and more aggressive breast tumors and, as a result, more frequently received adjuvant chemotherapy and lymph node irradiation. Small differences in treatment-related toxicities and cosmesis were observed, but no differences in efficacy were identified.",
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T1 - Differences in disease presentation, management techniques, treatment outcome, and toxicities in African-American women with early stage breast cancer treated with breast-conserving therapy

AU - Vicini, Frank

AU - Jones, Pamela

AU - Rivers, Aeisha

AU - Wallace, Michelle

AU - Mitchell, Chris

AU - Kestin, Larry

AU - Jaiyesimi, Ishmael

AU - Dekhne, Nayana

AU - Martinez, Alvaro

PY - 2010/7/15

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N2 - BACKGROUND: Data on patients who received breast-conserving therapy (BCT) for early stage breast cancer were examined to detect differences in disease presentation, management techniques, long-term treatment outcomes, and toxicities based on race. METHODS: Six hundred ninety-nine women with breast cancer (39 African-American [AA] women and 660 Caucasian [C] women) who received BCT were analyzed on race, clinical and pathologic characteristics at presentation, management techniques, treatment-related toxicities, recurrence, and survival. The median follow-up was 12.2 years. RESULTS: At diagnosis, AA women were younger (aged <50 years, 49% vs 29%; P = .002), had larger tumors (mean, 17.0 mm vs 13.9 mm; P = .032), had more estrogen receptor-negative tumors (56% vs 18%; P < .001), and higher nuclear grade tumors (grade 3, 52% vs 29%; P = .006). Compared with C women, AA women more frequently received adjuvant chemotherapy (59% vs 19%; P < .001) and lymph node irradiation (26% vs 13%; P = .033). No other significant treatment differences were observed. After treatment, AA women experienced more breast pain (P = .001), more arm edema (P = .046), and less excellent cosmetic results (P = .008), but there were no statistically significant differences in local recurrence (P = .232), distant metastasis (P = .263), overall survival (P = .131), or cause-specific survival (P = .092) based on race. CONCLUSIONS: The current results suggested that AA women present with larger and more aggressive breast tumors and, as a result, more frequently received adjuvant chemotherapy and lymph node irradiation. Small differences in treatment-related toxicities and cosmesis were observed, but no differences in efficacy were identified.

AB - BACKGROUND: Data on patients who received breast-conserving therapy (BCT) for early stage breast cancer were examined to detect differences in disease presentation, management techniques, long-term treatment outcomes, and toxicities based on race. METHODS: Six hundred ninety-nine women with breast cancer (39 African-American [AA] women and 660 Caucasian [C] women) who received BCT were analyzed on race, clinical and pathologic characteristics at presentation, management techniques, treatment-related toxicities, recurrence, and survival. The median follow-up was 12.2 years. RESULTS: At diagnosis, AA women were younger (aged <50 years, 49% vs 29%; P = .002), had larger tumors (mean, 17.0 mm vs 13.9 mm; P = .032), had more estrogen receptor-negative tumors (56% vs 18%; P < .001), and higher nuclear grade tumors (grade 3, 52% vs 29%; P = .006). Compared with C women, AA women more frequently received adjuvant chemotherapy (59% vs 19%; P < .001) and lymph node irradiation (26% vs 13%; P = .033). No other significant treatment differences were observed. After treatment, AA women experienced more breast pain (P = .001), more arm edema (P = .046), and less excellent cosmetic results (P = .008), but there were no statistically significant differences in local recurrence (P = .232), distant metastasis (P = .263), overall survival (P = .131), or cause-specific survival (P = .092) based on race. CONCLUSIONS: The current results suggested that AA women present with larger and more aggressive breast tumors and, as a result, more frequently received adjuvant chemotherapy and lymph node irradiation. Small differences in treatment-related toxicities and cosmesis were observed, but no differences in efficacy were identified.

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KW - Breast cancer

KW - Breast-conserving therapy

KW - Racial disparities

KW - Radiation

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