Local recurrence and survival among black women with early-stage breast cancer treated with breast-conservation therapy or mastectomy.
BACKGROUND
Black women with breast cancer have significantly worse survival rates and receive diagnoses at relatively younger ages, compared with white patients with breast cancer, in the United States. Young age at diagnosis has been associated with increased risk for local recurrence (LR) after breast-conservation therapy (BCT). The goal of this study was to evaluate the impact of age and BCT on LR and survival rates among black patients with breast cancer.


METHODS
The records for 363 black women treated for breast cancer (excluding stage IV disease) at a comprehensive cancer center were reviewed.


RESULTS
Fifty-eight percent of patients (n = 211) had tumors < or = 5 cm in diameter. Forty-two of these patients (19.9%) received BCT; the LR rate for this group was 9.8%. A total of 168 patients (79.6%) underwent mastectomy; the LR rate for this group was 8.9%. Data on the primary operation were unavailable for one patient. Five-year disease-free survival rates were similar for patients treated with BCT and those treated with mastectomy (88% and 73%, respectively). LR was associated with significant decreases in 5-year overall survival rates for both the BCT group (67% vs. 95%, P < .01) and the mastectomy group (43% vs. 76%, P < .01). LR and 5-year disease-specific survival rates were similar for patients <50 years of age and patients > or = 50 years of age, regardless of treatment.


CONCLUSIONS
LR and survival rates are not compromised by the use of BCT among black American patients. LR is associated with an increased risk of breast cancer death, regardless of treatment type. Younger age at diagnosis was not associated with an increased rate of LR after BCT in this series.
Newman
L A
LA
Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
Kuerer
H M
HM
Hunt
K K
KK
Singh
G
G
Ames
F C
FC
Feig
B W
BW
Ross
M I
MI
Taylor
S
S
Singletary
S E
SE
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People; D001943:Breast Neoplasms / Q000453:epidemiology / Q000208:ethnology* / Q000601:surgery*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental / Q000706:statistics & numerical data*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D018714:Radiotherapy, Adjuvant; D015996:Survival Rate; D013781:Texas / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D001741:Black or African American