Minorities Most Likely to Have Aggressive Tumors, Less Likely to Get Radiation
- Breast tumor aggressiveness increased receipt of chemotherapy, decreased adjuvant radiation utilization.
- Adjuvant radiation still under-recommended.
- Receiving chemotherapy decreased likelihood of radiation.
SAN DIEGO — Women with aggressive breast cancer were more likely to receive adjuvant chemotherapy, but at the expense of completing locoregional radiation therapy, according to recently presented data. This was especially true in minorities, who were the most likely to present with moderate- to high-grade and symptomatically detected tumors.
“Radiation treatment decreases the risk for breast cancer recurring and improves survival from the disease,” said Abigail Silva, M.P.H., Susan G. Komen Cancer Disparities Research trainee at the University of Illinois in Chicago, who presented the results at the Fifth AACR Conference on The Science of Cancer Health Disparities, held here Oct. 27-30, 2012.
Prior studies have shown that black and Hispanic women are less likely than white women to obtain radiation treatment when eligible, and this may partly explain racial/ethnic disparities in breast cancer outcomes, according to Silva.
To further examine factors in disparities in guideline-concordant radiation treatment, Silva and colleagues gathered interview and medical record data from a population-based study of patients with single invasive primary tumors, including 397 non-Hispanic whites, 411 non-Hispanic blacks and 181 Hispanics.
Of the patients who consented to medical record abstraction and were eligible for radiation treatment, 88 percent received a recommendation for radiation treatment and 93 percent of those patients accepted treatment. However, only 97 percent of patients who accepted treatment actually received radiation. Therefore, initiation occurred in only 79 percent of the initial population of women who were eligible for radiation treatment.
Data indicated that minority women were less likely to initiate radiation treatment compared with non-Hispanic white women. In addition, minority women were more likely to have moderate- to high-grade tumors and symptomatically detected tumors.
“We also found that patients who got chemotherapy were less likely to get radiation when they needed it,” Silva said. “Because minorities tended to have more aggressive breast cancer that more often required chemotherapy, this disproportionately affected them.”
Given these results, Silva and colleagues said clinicians may not be recommending guideline-concordant radiation treatment to all eligible patients.
“Indeed, we found that once a treatment recommendation was made, the vast majority of patients received treatment,” Silva said. “In addition, greater diffusion of gene expression profiling may improve cancer care, not only by reducing overuse of chemotherapy but by eliminating chemotherapy as a potential barrier to receipt of radiation.”
In the next phase of their research, Silva and colleagues plan to examine the role of mutable patient factors such as social support, cultural beliefs and provider mistrust, which may help explain the disparity in initiation of radiation treatment.
About the American Association for Cancer Research
Founded in 1907, the American Association for Cancer Research (AACR) is the world’s first and largest professional organization dedicated to advancing cancer research and its mission to prevent and cure cancer. AACR membership includes more than 34,000 laboratory, translational and clinical researchers; population scientists; other health care professionals; and cancer advocates residing in more than 90 countries. The AACR marshals the full spectrum of expertise of the cancer community to accelerate progress in the prevention, biology, diagnosis and treatment of cancer by annually convening more than 20 conferences and educational workshops, the largest of which is the AACR Annual Meeting with more than 17,000 attendees. In addition, the AACR publishes seven peer-reviewed scientific journals and a magazine for cancer survivors, patients and their caregivers. The AACR funds meritorious research directly as well as in cooperation with numerous cancer organizations. As the scientific partner of Stand Up To Cancer, the AACR provides expert peer review, grants administration and scientific oversight of team science and individual grants in cancer research that have the potential for near-term patient benefit. The AACR actively communicates with legislators and policymakers about the value of cancer research and related biomedical science in saving lives from cancer.
For more information about the AACR, visit www.AACR.org.
In San Diego, Oct. 27-30: