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:3/28/2017)... ... March 28, 2017 , ... WHO: , Dr. Paul ... , WHAT: , Medical doctors and PhD scientists will speak to the press on ... Trump in support of an independent vaccine safety commission. , WHERE: , Zenger ...
(Date:3/28/2017)... ... March 28, 2017 , ... Qualidigm ... its corporate headquarters to a new, more expansive office space in order to ... Qualidigm purchased a distressed office building in Wethersfield, Conn. located at 936 Silas ...
(Date:3/28/2017)... ... 28, 2017 , ... The Executives, Staff & Clients of MGE: Management Experts ... for Tots Literacy Campaign at their Semi-Annual Graduation and Fundraiser Event at MGE’s St. ... ranks at number 14 internationally in literacy. Statistically, a direct relation can be a ...
(Date:3/28/2017)... , ... March 28, 2017 , ... Public relations pros ... across a variety of business channels. , While many results are clear, much of ... relations program. , When it comes to measurement, firms should always take an ...
(Date:3/28/2017)... ... March 28, 2017 , ... Thank you to all who attended ... , This event was exclusive to providers and offered an opportunity to collaborate ... place at the Manchester Grand Hyatt where attendees gathered for a lively discussion on ...
Breaking Medicine News(10 mins):
(Date:3/28/2017)... ROCKVILLE, Md. , March 28, 2017 /PRNewswire/ ... dedicated to innovative therapeutics addressing cancer and other ... at the American Association for Cancer Research annual ... April 3 is entitled "Evaluation of ENMD-2076 ... and the second poster to be presented ...
(Date:3/28/2017)... Elysium Health joins major pharmaceutical ... Cambridge academic scientists through ... Milner Therapeutics Institute today announces Elysium Health as a partner ... investment for collaborative projects with academic researchers in ... the first major research investment outside the U.S. for the ...
(Date:3/27/2017)... WAUKESHA, Wis. , March 27, 2017  A ... one of only four freestanding hospitals in the country ... in plastic and reconstructive surgery, concluded that the Surfacide ... effective and integral component in reducing bacterial pathogens not ... The findings were published at the American Burn Association,s ...
Breaking Medicine Technology: