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Title: Outcomes in Black Patients With Early Breast Cancer Treated With Breast Conservation Therapy

Abstract

Background: The race-specific impact of prognostic variables for early breast cancer is unknown for black patients undergoing breast conservation. Methods and Materials: This was a retrospective study of 1,231 consecutive patients {>=}40 years of age with Stage I-II invasive breast cancer treated with lumpectomy and radiation therapy at the University of Chicago Hospitals and affiliates between 1986 and 2004. Patients were classified as either black or nonblack. Cox proportional hazards regression was used to model the effects of known prognostic factors and interactions with race. Results: Median follow-up for surviving patients was 82 months. Thirty-four percent of patients were black, and 66% were nonblack (Caucasian, Hispanic, and Asian). Black patients had a poorer 10-year overall survival (64.6% vs. 80.8%; adjusted hazard ratio [HR], 1.59; 95% confidence interval [CI], 1.23-2.06) and 10-year disease-free survival (58.1% vs. 75.4%; HR 1.49; 95% CI, 1.18-1.89) compared with nonblack patients. Tumor sizes were similar between nonblack and black patients with mammographically detected tumors (1.29 cm vs. 1.20 cm, p = 0.20, respectively). Tumor size was significantly associated with overall survival (HR 1.48; 95% CI, 1.12-1.96) in black patients with mammographically detected tumors but not in nonblack patients (HR 1.09; 95% CI, 0.78-1.53), suggesting that survivalmore » in black patients depends more strongly on tumor size in this subgroup. Tests for race-size method of detection interactions were statistically significant for overall survival (p = 0.049), locoregional control (p = 0.036), and distant control (p = 0.032) and borderline significant for disease-free survival (p = 0.067). Conclusion: Despite detection at comparable sizes, the prognostic effect of tumor size in patients with mammographically detected tumors is greater for black than in nonblack patients.« less

Authors:
; ;  [1];  [2]; ; ; ;  [1];  [1]
  1. Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL (United States)
  2. Department of Health Studies, University of Chicago, Chicago, IL (United States)
Publication Date:
OSTI Identifier:
21491576
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 79; Journal Issue: 2; Other Information: DOI: 10.1016/j.ijrobp.2009.11.017; PII: S0360-3016(09)03550-0; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BLACK AMERICANS; MAMMARY GLANDS; NEOPLASMS; RADIOTHERAPY; SIZE; SURGERY; SURVIVAL CURVES; BODY; DISEASES; GLANDS; HUMAN POPULATIONS; MEDICINE; MINORITY GROUPS; NUCLEAR MEDICINE; ORGANS; POPULATIONS; RADIOLOGY; THERAPY

Citation Formats

Nichols, Michael A., Mell, Loren K., Hasselle, Michael D., Karrison, Theodore G., MacDermed, Dhara, Meriwether, Amber, Witt, Mary Ellyn, Weichselbaum, Ralph R., and Chmura, Steven J., E-mail: schmura@radonc.uchicago.ed. Outcomes in Black Patients With Early Breast Cancer Treated With Breast Conservation Therapy. United States: N. p., 2011. Web. doi:10.1016/j.ijrobp.2009.11.017.
Nichols, Michael A., Mell, Loren K., Hasselle, Michael D., Karrison, Theodore G., MacDermed, Dhara, Meriwether, Amber, Witt, Mary Ellyn, Weichselbaum, Ralph R., & Chmura, Steven J., E-mail: schmura@radonc.uchicago.ed. Outcomes in Black Patients With Early Breast Cancer Treated With Breast Conservation Therapy. United States. doi:10.1016/j.ijrobp.2009.11.017.
Nichols, Michael A., Mell, Loren K., Hasselle, Michael D., Karrison, Theodore G., MacDermed, Dhara, Meriwether, Amber, Witt, Mary Ellyn, Weichselbaum, Ralph R., and Chmura, Steven J., E-mail: schmura@radonc.uchicago.ed. Tue . "Outcomes in Black Patients With Early Breast Cancer Treated With Breast Conservation Therapy". United States. doi:10.1016/j.ijrobp.2009.11.017.
@article{osti_21491576,
title = {Outcomes in Black Patients With Early Breast Cancer Treated With Breast Conservation Therapy},
author = {Nichols, Michael A. and Mell, Loren K. and Hasselle, Michael D. and Karrison, Theodore G. and MacDermed, Dhara and Meriwether, Amber and Witt, Mary Ellyn and Weichselbaum, Ralph R. and Chmura, Steven J., E-mail: schmura@radonc.uchicago.ed},
abstractNote = {Background: The race-specific impact of prognostic variables for early breast cancer is unknown for black patients undergoing breast conservation. Methods and Materials: This was a retrospective study of 1,231 consecutive patients {>=}40 years of age with Stage I-II invasive breast cancer treated with lumpectomy and radiation therapy at the University of Chicago Hospitals and affiliates between 1986 and 2004. Patients were classified as either black or nonblack. Cox proportional hazards regression was used to model the effects of known prognostic factors and interactions with race. Results: Median follow-up for surviving patients was 82 months. Thirty-four percent of patients were black, and 66% were nonblack (Caucasian, Hispanic, and Asian). Black patients had a poorer 10-year overall survival (64.6% vs. 80.8%; adjusted hazard ratio [HR], 1.59; 95% confidence interval [CI], 1.23-2.06) and 10-year disease-free survival (58.1% vs. 75.4%; HR 1.49; 95% CI, 1.18-1.89) compared with nonblack patients. Tumor sizes were similar between nonblack and black patients with mammographically detected tumors (1.29 cm vs. 1.20 cm, p = 0.20, respectively). Tumor size was significantly associated with overall survival (HR 1.48; 95% CI, 1.12-1.96) in black patients with mammographically detected tumors but not in nonblack patients (HR 1.09; 95% CI, 0.78-1.53), suggesting that survival in black patients depends more strongly on tumor size in this subgroup. Tests for race-size method of detection interactions were statistically significant for overall survival (p = 0.049), locoregional control (p = 0.036), and distant control (p = 0.032) and borderline significant for disease-free survival (p = 0.067). Conclusion: Despite detection at comparable sizes, the prognostic effect of tumor size in patients with mammographically detected tumors is greater for black than in nonblack patients.},
doi = {10.1016/j.ijrobp.2009.11.017},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 2,
volume = 79,
place = {United States},
year = {2011},
month = {2}
}