(ChemotherapyAdvisor) – Among US breast cancer patients, African-American and Hispanic women are the most likely to be diagnosed with moderate- to high-grade and symptomatic tumors, but the least likely to undergo radiotherapy, according to a population-based study presented at the Fifth AACR Conference on The Science of Cancer Health Disparities, San Diego, CA.
“Radiation treatment decreases the risk for breast cancer recurring and improves survival from the disease,” reported lead author Abigail Silva, MD, of the University of Illinois School of Public Health’s Division of Epidemiology and Biostatistics in Chicago, IL, and her coauthors. “Patients who are eligible for radiation and have more aggressive appearing tumors at diagnosis are more likely to receive chemotherapy but at the expense of completing their locoregional (radiation) therapy. This disproportionately affects minority patients and results in underuse of radiation in these women.”
The researchers analyzed interview and medical records data for 614 women diagnosed with a single invasive primary breast tumor during 2005 to 2008, of whom 443 (72%) were deemed eligible for radiotherapy under National Comprehensive Cancer Network (NCCN) guidelines.
“Radiation treatment was recommended to 88% of eligible patients, of which 93% accepted it,” the authors noted. “This translated into an overall treatment initiation of 79%. Minority patients were less likely than non-Hispanic White patients to initiate radiation.”
Minorities were more likely to be diagnosed with symptomatically-detected, moderate-to-high-grade tumors, “which in turn were less likely to receive radiation (all Ps<0.01),” they reported. “Minority women were also more likely than non-Hispanic White women (P<0.0001) to receive chemotherapy, which in turn was associated with lower receipt of radiotherapy (P<0.05).”
“Greater diffusion of gene expression profiling (e.g., Oncotype) may improve cancer care not only by reducing overuse of chemotherapy but by eliminating chemotherapy as a potential barrier to receipt of radiotherapy,” Dr. Silva said.