Black women less likely to receive radiation after lumpectomy

NEW YORK (Reuters Health) - Black women are significantly less likely than white women to receive standard radiation therapy after lumpectomy for early-stage breast cancer. These disparities vary widely by region of the United States, according to research presented Wednesday ahead of the 2008 Breast Cancer Symposium, which opens Friday in Washington, D.C.

"We don't know if fewer black women are receiving radiation therapy because it is not offered to them, because they decline the treatment, or because they are unable to complete a whole course of treatment," said study leader Dr. Grace L. Smith of the University of Texas MD Anderson Cancer Center, Houston.

Dr. Smith and colleagues studied the Medicare records of women aged 66 or older who were treated with conservative surgery for early-stage, newly diagnosed breast cancer in 2003. Among a total of 37,305 women, 34,024 were white and 2,305 were black.

They found that 74% of white women received radiation therapy after lumpectomy, compared with only 65% of black women - a significant difference.

Even among women younger than age 70, Dr. Smith noted, "in whom radiation would be expected to be most common," the racial disparities persisted, with only 71% of black women receiving radiation after lumpectomy compared with 81% of white women.

"This difference is concerning given that radiation treatment after lumpectomy is generally considered standard therapy," she added.

The data also show significant geographic variation in the degree of racial disparities in how often women underwent radiation therapy after lumpectomy. The most pronounced racial disparities in radiation use were seen in the East South Central region of the US, the Pacific West, and the Northeast.

"Only slightly more than half (55% to 58%) of black women with breast cancer living in these regions received radiation after lumpectomy and this compared with 70% to 72% of white women living in these regions who received radiation after lumpectomy," Dr. Smith said.

Dr. Eric Winer, director of the breast oncology center at Dana-Farber Cancer Institute, Boston and moderator of the press briefing noted that "for all but the oldest and sickest women, radiation should be considered standard after lumpectomy -- so it's actually quite surprising that the rates of radiation across the board are as low as they are and this is something that has been seen in other studies as well."

"We need to identify and correct the obstacles that are causing these disparities, and work to increase awareness about the benefits of radiation therapy following lumpectomy," Dr. Smith concluded.

The Breast Cancer Symposium is co-sponsored by the American Society of Breast Disease, the American Society of Breast Surgeons, the American Society of Clinical Oncology, the American Society of Therapeutic Radiology and Oncology, the National Consortium of Breast Centers, Inc., and the Society of Surgical Oncology.

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