More whites than blacks get breast cancer chemo

October 16, 2007

NEW YORK (Reuters Health) - For many different reasons, African American women do not receive add-on therapy after breast cancer as often as white American women do, a new study shows.

"Some of it has to do with socioeconomics, some with insurance status and/or access to care, but there are choice issues as well, especially with chemotherapy," study leader Dr. Mousumi Banerjee, noted in a statement from the University of Michigan School of Public Health.

In an attempt to disentangle the effects of race on breast cancer treatment, Banerjee and colleagues in Ann Arbor analyzed data on 651 African American and white American women diagnosed with breast cancer between 1990 and 1996.

Mirroring other studies, they found that African American women were more likely than white women to have more advanced-stage disease. African American women were also more likely than white women to be unmarried, have government insurance, live in poor neighborhoods and have more other illnesses, according to the report in the medical journal Cancer.

In analyses accounting for these factors, African American women with early-stage disease were just as likely as white women to undergo breast-sparing surgery rather than mastectomy, and to be treated with tamoxifen and adjuvant (i.e., add-on) chemotherapy.

However, among women with more advanced acncer, whites were nearly five times more likely to be given tamoxifen and more than three times more likely to receive chemotherapy.

The results also showed that women with early-stage breast cancer who had government-provided health insurance were less likely to undergo combined breast-conserving surgery and radiation and more likely to undergo mastectomy without radiation than women enrolled in non-governmental insurance plans or private insurance plans.

"The results from this study," Banerjee and colleagues conclude, "may be used to target educational interventions to improve the use of adjuvant therapies among African American women."