Black women with early stage breast cancer less likely to receive full course of chemotherapy

October 12, 2005

Black women with stage I or II breast cancer are more likely than their counterparts of other races to abandon chemotherapy before completing their full course of treatment, according to a recent Columbia University Medical Center study.

Published in the Journal of Clinical Oncology (Sept. 20, 2005), the findings shed new light on why breast black cancer patients experience lower survival rates than other women, despite a lower incidence.

"This study is the first to correlate early termination of chemotherapy with racial disparities in breast cancer outcomes," said Dawn Hershman, M.D., M.S., assistant professor of medicine and epidemiology at Columbia University College of Physicians & Surgeons and the Mailman School of Public Health, and the study's lead investigator.

Dr. Hershman and her research team set out to study the association between race and survival with duration of treatment and number of completed chemotherapy cycles. They analyzed the data of 472 stage I and II breast cancer patients enrolled in the tumor registry of the Henry Ford Health System, a large Detroit-area healthcare provider, between 1996 and 2001.

The investigators determined that women who discontinued treatment were more likely to be black and more likely to die than those who completed full chemotherapy cycles. Key findings include:"These findings confirm the vital need for breast cancer patients to complete the chemotherapy treatment cycles that are often essential to survival," said Dr. Hershman.

Many issues are thought to be a factor in poor compliance among black women: inadequate physician-patient communication and social-support networks, treatment toxicity, racial differences in drug metabolism, comorbidities and other health complications, e.g., lower white blood cell counts (an indication of a weaker immune state, which can cause delays in the administration of chemotherapy cycles).

"Further study is warranted to identify barriers to compliance. However, it's vital that all women are well-educated about the risks of terminating treatment early. In the long-run, improving the quality of breast cancer treatment may prove to be as important as screening and education."
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Columbia University Medical Center provides international leadership in pre-clinical and clinical research, in medical and health sciences education, and in patient care. The medical center trains future leaders in health care and includes the dedicated work of many physicians, scientists, nurses, dentists, and public health professionals at the College of Physicians & Surgeons, the School of Dental & Oral Surgery, the School of Nursing, the Mailman School of Public Health, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Columbia University Medical Center researchers are leading the discovery of novel therapies and advances to address a wide range of health conditions. www.cumc.columbia.edu

Columbia University Medical Center

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