Navigation Links
Racial disparities in sentinel lymph node biopsy in women with breast cancer
Date:6/18/2014

The use of sentinel lymph node biopsy (SLNB) to stage early breast cancer increased in both black and white women from 2002 to 2007, but the rates remained lower in black than white patients, a disparity that contributed to disparities in the risk for lymphedema (arm swelling common after breast cancer treatment because of damage to the lymphatic system).

SLNB was developed to replace axillary (arm pit) lymph node dissection (ALND) for staging early breast cancer to minimize complications. SLNB can often provide patients with a much more limited surgery. Racial disparities exist in many aspects of breast cancer care but their existence in the use of SLNB had been uncharacterized.

Researchers identified cases of nonmetastatic, node-negative breast cancer in women 66 years of age or older from 2002 through 2007. Of the 31,274 women identified, 1,767 (5.6 percent) were black, 27,856 (89.1 percent) were white and 1,651 (5.3 percent) were of other or unknown race.

SLNB was performed in 73.7 percent of white patients and 62.4 percent of black patients. While the use of SLNB increased by year for both black and white patients, blacks were 12 percent less likely than whites throughout the study period to undergo SLNB. The authors suggest that adoption of SLNB in blacks patients lagged two to three years behind its adoption in white patients. The 5-year cumulative lymphedema risk was 8.2 percent in whites and 12.3 percent in blacks. The authors note socioeconomic and geographic factors were associated with lower SLNB use including insurance coverage through Medicaid, living in areas with lower education or income levels, and living in areas with fewer surgeons.

"These findings emphasize that not all newly developed techniques in breast cancer care are made available in a timely fashion to all eligible patients. As new techniques continue to be developed, focused educational interventions must be developed to ensure that these techniques reach historically disadvantaged patients to avoid disparities in care. More contemporary data will be needed to determine whether this disparity still exists in black patients and other at-risk minorities."

Author: Dalliah M. Black, M.D., of the University of Texas MD Anderson Cancer Center, Houston, Texas.

(JAMA Surgery. Published online June 18, 2014. doi:10.1001/jamasurg.2014.23. Available pre-embargo to the media at http://media.jamanetwork.com.)

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Commentary: Racial Disparities in Breast Cancer More Bad News

In a related commentary, Colleen D. Murphy, M.D., and Richard D. Schulick, M.D., M.B.A., of the University of Colorado, Aurora, write: "One key and uncertain issue in the study of lymphedema is its very diagnosis."

"In the study by Black and colleagues, it seems likely that patients undergoing axillary lymph node dissection, when sentinel node biopsy may have been indicated, were cared for at institutions without lymphedema screening protocols. In black women, lymphedema screening may be especially relevant; Black et al have demonstrated that this population is at highest risk," they continue.

"Black and colleagues have highlighted another disparity in breast cancer care and its associated morbidity. With this information in hand, we should seek to eliminate these differences as much as possible."

(JAMA Surgery. Published online June 18, 2014. doi:10.1001/jamasurg.2014.44. Available pre-embargo to the media at http://media.jamanetwork.com.)

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.


'/>"/>

Contact: Julie A. Penne
jpenne@mdanderson.org
713-792-0662
The JAMA Network Journals
Source:Eurekalert

Related medicine news :

1. UC Irvine study finds racial, economic disparities in ovarian cancer care, survival
2. Racial make-up of community impacts obesity risk
3. Racial Gap in Kids Dental Care Vanishing: Study
4. Multiracial youths show similar vulnerability to peer pressure as whites
5. New CDC study on racial disparities in infant mortality published in Journal of Womens Health
6. Black gay men worldwide 15 times more likely to have HIV and racial disparity
7. Racial differences in diabetes diagnostic thresholds
8. Vanderbilt-led study reveals racial disparities in prostate cancer care
9. CT depicts racial differences in coronary artery disease
10. Are there racial disparities in osteoporosis screening and treatment?
11. Racial Disparities Still Seen in Use of Breast Cancer Treatments
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:1/21/2017)... ... January 21, 2017 , ... Pacifica Graduate ... the electrifying line-up of events for its annual meeting “Coming Home 2017,” an ... “Coming Home 2017” will be held on Friday January 27 through Sunday, ...
(Date:1/21/2017)... ... January 21, 2017 , ... In the United States, 20 million ... freedom of recovery, they often feel shame for having struggled with an eating disorder ... In the workshop, “Rising Strong in Life After an Eating Disorder” -- to be ...
(Date:1/20/2017)... (PRWEB) , ... January 20, 2017 , ... A new ... donate items they no longer use or need, from clothes to couches to dressers ... unwanted items and take them to the nearest Goodwill donation center through February 28th. ...
(Date:1/20/2017)... ... January 20, 2017 , ... Doctor C LLC, a company based ... ECRM trade show to continue the marketing and distribution of its product, The Right ... providing 400 percent better absorption than traditional vitamin C supplements. At the trade show, ...
(Date:1/20/2017)... ... January 20, 2017 , ... ... to enhance people’s everyday lives, recently attended the January ECRM Trade Show in ... Science is known for its large range of supplements that keep the body ...
Breaking Medicine News(10 mins):
(Date:1/20/2017)... January 20, 2017 ... an Nothilfe   Die internationale humanitäre Stadt soll ... zu schaffen   Seine Hoheit Scheich ... VAE sowie Herrscher von Dubai , ... der Hilfe (International Humanitarian City IHC) zu verdreifachen, um ...
(Date:1/19/2017)... , Jan. 19, 2017 The global ... billion by 2025, according to a new study ... anticipated to be predominantly driven by high R&D ... the large-scale production of new and therapeutically advanced ... of drugs at an unprecedented rate into the ...
(Date:1/19/2017)... Jan. 19, 2017 The U.S. Food and Drug ... Idiopathic Constipation (CIC) in adult patients. "No ... disorders," said Julie Beitz , M.D., director of the ... Drug Evaluation and Research. "With the availability of new therapies, ... for their condition." ...
Breaking Medicine Technology: