Study finds difference in survival rates among white and black women with advanced breast cancer

June 03, 2007

CHICAGO - Despite modest overall improvements in breast cancer survival rates for women with advanced disease over the last two decades, the rates for black women have not improved and the difference in life expectancy between white and black women continues to widen, according to researchers at The University of Texas M. D. Anderson Cancer Center.

The study, presented today (June 3) at the 43rd annual American Society of Clinical Oncology (ASCO), is the first to show that improvements in breast cancer survival only benefit white women and that the disparity between black and white breast cancer patients is widening.

The study evolved as a follow-up to recent research of Sharon Giordano, M.D., assistant professor in M. D. Anderson's Department of Breast Medical Oncology, that found an overall improvement in the survival of Stage IV breast cancer patients enrolled in clinical trials at M. D. Anderson.

"We wanted to expand our research and look to a bigger subset of patients treated in the community to see if we would find similar results," says Shaheena Dawood, M.D., a Susan G. Komen Fellow in Breast Medical Oncology at M. D. Anderson. "We thought we would find that there was improvement in women with Stage IV breast cancer regardless if patients were white or black, with white women likely having better outcomes. Rather, over the decades, we found that black women's survival did not improve at all."

The researchers analyzed the National Cancer Institute's Surveillance Epidemiology and End Results (SEER) database to identify 15,438 women who were newly diagnosed with advanced breast cancer between 1988 and 2003. Adjustment factors included: patient age; estrogen receptor status; and tumor grade.

Patients were divided into three subgroups: those diagnosed from1988 to 1993; from 1994 to 1998; and from 1999 to 2003. Overall, the median age of the women was 62 years old; median breast cancer-specific survival was 20 months, 21 months and 25 months respectively.

In those diagnosed with advanced breast cancer between 1988 and 1993, the median survival was 20 months in white women, compared to 17 months for black women, a one-year survival difference of 2.8 percent. In the women diagnosed between 1994 and 1998, a white breast cancer patient's median survival was 22 months versus 16 months in black patients, a one-year survival difference of 6.8 percent. In those diagnosed from 1999 to 2003, the median survival for white women was 27 months compared to 17 months for black women, a one-year survivor difference of 8.8 percent.

"We do not suspect that these statistics are due to the biology of the disease because we would not expect the biology to change over time. It's more likely due to socio-economic factors," says Giordano, the study's senior author. "While SEER data does not code for treatment, we hypothesize that lack of access to healthcare and to newer modalities for treatment of Stage IV breast cancer, such as targeted therapies like Herceptin and aromotase inhibitors, are two contributing factors for the growing disparity."

In 2007, more than 180,510 women will be diagnosed with breast cancer and approximately 40,910 women are expected to die from the disease, according to the American Cancer Society. Of the new cases of breast cancer, the researchers say that 10 percent of the patients are diagnosed with metastatic breast cancer and that mortality rates for women with advanced breast disease are decreasing by 2.3 percent annually.

The researchers hope that health policy makers take notice of the growing disparity and implement steps to make all breast cancer treatments more accessible. Giordano and Dawood also intend to expand upon their research and determine the causation of these racial disparities.
Dr. Giordano is supported by NIH KO7 CA 109064-03.

University of Texas M. D. Anderson Cancer Center

Related Breast Cancer Articles from Brightsurf:

Oncotarget: IGF2 expression in breast cancer tumors and in breast cancer cells
The Oncotarget authors propose that methylation of DVDMR represents a novel epigenetic biomarker that determines the levels of IGF2 protein expression in breast cancer.

Breast cancer: AI predicts which pre-malignant breast lesions will progress to advanced cancer
New research at Case Western Reserve University in Cleveland, Ohio, could help better determine which patients diagnosed with the pre-malignant breast cancer commonly as stage 0 are likely to progress to invasive breast cancer and therefore might benefit from additional therapy over and above surgery alone.

Partial breast irradiation effective treatment option for low-risk breast cancer
Partial breast irradiation produces similar long-term survival rates and risk for recurrence compared with whole breast irradiation for many women with low-risk, early stage breast cancer, according to new clinical data from a national clinical trial involving researchers from The Ohio State University Comprehensive Cancer Center - Arthur G.

Breast screening linked to 60 per cent lower risk of breast cancer death in first 10 years
Women who take part in breast screening have a significantly greater benefit from treatments than those who are not screened, according to a study of more than 50,000 women.

More clues revealed in link between normal breast changes and invasive breast cancer
A research team, led by investigators from Georgetown Lombardi Comprehensive Cancer Center, details how a natural and dramatic process -- changes in mammary glands to accommodate breastfeeding -- uses a molecular process believed to contribute to survival of pre-malignant breast cells.

Breast tissue tumor suppressor PTEN: A potential Achilles heel for breast cancer cells
A highly collaborative team of researchers at the Medical University of South Carolina and Ohio State University report in Nature Communications that they have identified a novel pathway for connective tissue PTEN in breast cancer cell response to radiotherapy.

Computers equal radiologists in assessing breast density and associated breast cancer risk
Automated breast-density evaluation was just as accurate in predicting women's risk of breast cancer, found and not found by mammography, as subjective evaluation done by radiologists, in a study led by researchers at UC San Francisco and Mayo Clinic.

Blood test can effectively rule out breast cancer, regardless of breast density
A new study published in PLOS ONE demonstrates that Videssa® Breast, a multi-protein biomarker blood test for breast cancer, is unaffected by breast density and can reliably rule out breast cancer in women with both dense and non-dense breast tissue.

Study shows influence of surgeons on likelihood of removal of healthy breast after breast cancer dia
Attending surgeons can have a strong influence on whether a patient undergoes contralateral prophylactic mastectomy after a diagnosis of breast cancer, according to a study published by JAMA Surgery.

Young breast cancer patients undergoing breast conserving surgery see improved prognosis
A new analysis indicates that breast cancer prognoses have improved over time in young women treated with breast conserving surgery.

Read More: Breast Cancer News and Breast Cancer Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to