Racial Disparities in Radiation Therapy for Early-Stage Breast Cancer

Black women are less likely than white women to receive radiation therapy after a lumpectomy, the standard of care for early-stage breast cancer, according to a recent study by researchers at MD Anderson.

In this study, the largest of its kind and the first to examine such racial disparities in radiation therapy, the researchers reviewed the Medicare records of more than 37,000 patients diagnosed with early-stage breast cancer in 2003.

Of the 37,305 women who underwent a lumpectomy for their breast cancer, 34,024 were white and 2,305 were black.

Overall, 74% of the white women received radiation therapy after their lumpectomy; in contrast, 65% of the black breast cancer patients received the same treatment.

Thomas Buchholz, M.D.

“The use of radiation after lumpectomy is considered to be the standard of care for women with invasive breast cancer, as clinical trials have demonstrated that it both reduces the chance of recurrence and improves the chance of survival,” says Thomas Buchholz, M.D., professor and chair of the Department of Radiation Oncology at MD Anderson and the study’s senior author. “While there are some breast cancer patients, such as those over age 70, with significant co-morbidities for whom radiation would not be appropriate, this discrepancy remained consistent when specifically looking at patients under the age of 70.”

“Until further research is conducted, we may only speculate about the underlying reasons why black and white women are not receiving radiation at the same rate,” says Grace Li Smith, M.D., Ph.D., a postdoctoral fellow in MD Anderson’s Department of Radiation Oncology and the study’s first author.

“These questions will be important subjects of future study. As a medical community, we need to identify and eliminate any obstacle prohibiting all women from receiving necessary care for their breast cancer,” Smith says.

She hopes that results from the study may prompt physicians and patients to work together to overcome some of the barriers to treatment.

“Physicians may be able to help patients identify specific barriers to their care and overcome such obstacles,” Smith says. “Or, if there are concerns or misconceptions about radiation treatment, patients themselves may play a role by becoming educated about the value of radiation after lumpectomy and helping to disseminate this information into their communities.”

The research was first presented at the 2008 American Society of Clinical Oncology Breast Cancer Symposium and published in the December 2009 issue of Cancer.