Black Women Less Likely to Have Sentinel Lymph Node Biopsy
Racial Disparity Seen in Use of Sentinel Lymph Node Biopsy
While sentinel lymph node biopsy (SLNB) use has increased in all patients with breast cancer, black women are consistently less likely than white women to have SLNB, according to a study published online June 18 in JAMA Surgery.
Dalliah M. Black, M.D., from the University of Texas MD Anderson Cancer Center in Houston, and colleagues used data from the Surveillance, Epidemiology, and End Results-Medicare linked database (2002 through 2007) to identify cases of incident, nonmetastatic, pathologically node-negative breast cancer in 31,274 women (5.6 percent black; 89.1 percent white) aged 66 years or older. Use of sentinel lymph node biopsy and five-year cumulative incidence of lymphedema was evaluated by race.
The researchers found that sentinel lymph node biopsy was performed in 73.7 percent of white patients and 62.4 percent of black patients (P < .001). For both black and white patients, the use of SLNB increased by year (P < .001), although a fixed disparity of (approximately 12 percentage points) in SLNB use persisted through 2007. Black patients were significantly less likely than white patients to undergo SLNB (odds ratio, 0.67; P < .001) in adjusted analysis. In whites, the five-year cumulative lymphedema risk was 8.2 percent versus 12.3 percent in blacks (hazard ratio, 1.43; P < .001).
"This racial disparity in SLNB use contributed to racial disparities in lymphedema risk," the authors write.