"With this research, we wanted to determine if new surgical innovations were being incorporated fairly amongst different patient populations," says Black, also the study's first author. "This study looks at trends over time, comparing appropriate patients who all would have been candidates for the SLN biopsy to see how the new procedure was implemented in African Americans and Caucasians."
For the retrospective population-based study, the MD Anderson team used Medicare claims data between 2002 and 2007 from the Surveillance, Epidemiology and End Results (SEER) database to examine the surgical history of 31,274 women age 66 and older diagnosed with early-stage, invasive breast cancer. Of those women, 1,767 (5 percent) were African American, 27,856 (89 percent) were Caucasian and 1,651 (5.3 percent) were other, or of unknown race.
The researchers found that 62 percent of African American patients underwent the SLN biopsy, compared to 74 percent of the Caucasian patients. Although the SLN biopsy rate increased in both groups between 2002 and 2007, a fixed disparity persisted through the five years.
The five-year cumulative incidence of lymphedema was 12.1 percent in those who received ALN dissection, compared to 6.9 percent in those who received SLN biopsy. Overall, African Americans had a higher rate of the complication; however, among those patients who had the SLN biopsy, patients had similar risk of lymphedema, regardless of race.
"The risk of lymphedema was primarily driven by differences in treatment: ALN dissection resulted in about twice the risk. When we looked at outcomes stratified by tre
|Contact: Laura Sussman|
University of Texas M. D. Anderson Cancer Center