BOSTON--Despite significant differences in the severity of their diseases upon diagnosis, black and white women with breast cancer who are treated with lumpectomy followed by radiation therapy are equally likely to survive disease-free for at least five years and to achieve local control of their disease. The findings by a group of radiation oncologists at Emory University School of Medicine were presented Wednesday at the annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO) in Boston.
The researchers, led by Stuart H. Burri, M.D., and his Emory colleagues, conducted a retrospective review of the charts of 270 patients who were diagnosed with breast cancer, then radiotherapy at three Atlanta hospitals affiliated with Emory’s School of Medicine: Emory University Hospital, an academic medical center; Crawford Long Hospital, a community hospital; and Grady Memorial Hospital, an inner city public hospital. The review covered a period of four years.
The study group included 102 black patients and 162 white patients. Six non-black, non-white patients were not included. At initial diagnosis, 62.9% of the patients had stage I disease; 28% had grade III disease; 20.5% were node positive; 58.7% were estrogen receptor (ER) positive; and 51.9% were progesterone receptor (PR) positive.
The black patients presented with a greater proportion of unfavorable prognostic features. More black patients had higher-stage disease (Stage II: 43.1% vs. 32.12%) and more were node positive (29.4% vs. 14.8%). The black patients also were more likely to undergo a re-excision of their tumors and to have higher grade disease (Grade III: 35.3% vs. 24.1%). Despite the higher percentage of poor prognostic factors in the black patients, the local control (95.5% black vs. 94.8% white) and disease-free survival (90.3% black vs. 91.7% white) was excellent and equivalent to the white patients. There was no difference in either local control or disease-free survival among the three institutions.
"This study shows that patients with varying disease symptoms and severity of disease can benefit from advanced cancer treatments. Further research may help clarify why the initial differences resulted in substantially equal outcomes," said Lawrence Davis, M.D., professor and chairman of radiation oncology at Emory.
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