African American women less likely to receive axillary SLN biopsy for breast cancer

Published on December 6, 2012 at 3:33 AM · No Comments

African American women with early stage, invasive breast cancer were 12 percent less likely than Caucasian women with the same diagnosis to receive a minimally invasive technique, axillary sentinel lymph node (SLN) biopsy, years after the procedure had become the standard of surgical practice, according to research from The University of Texas MD Anderson Cancer Center.

The study, presented at the 2012 CTRC-AACR San Antonio Breast Cancer Symposium, also found that those African American women who underwent the older, more invasive procedure, axillary lymph node (ALN) dissection, had higher rates of lymphedema. The findings were presented today by Dalliah Mashon Black, M.D., assistant professor in MD Anderson's Department of Surgical Oncology.

SLN biopsy became accepted as standard of care for the staging of breast cancer in 2002 and the preferred practice by 2007 when the National Comprehensive Cancer Network and other national organizations endorsed the minimally-invasive procedure. The older technique, ALN dissection, is associated with a number of complications, including lymphedema. Black estimates that approximately 75 percent of newly diagnosed breast cancer patients are eligible for SLN biopsy.

"With this research, we wanted to determine if new surgical innovations were being incorporated fairly amongst different patient populations," says Black, also the study's first author. "This study looks at trends over time, comparing appropriate patients who all would have been candidates for the SLN biopsy to see how the new procedure was implemented in African Americans and Caucasians."

For the retrospective population-based study, the MD Anderson team used Medicare claims data between 2002 and 2007 from the Surveillance, Epidemiology and End Results (SEER) database to examine the surgical history of 31,274 women age 66 and older diagnosed with early-stage, invasive breast cancer. Of those women, 1,767 (5 percent) were African American, 27,856 (89 percent) were Caucasian and 1,651 (5.3 percent) were other, or of unknown race.

The researchers found that 62 percent of African American patients underwent the SLN biopsy, compared to 74 percent of the Caucasian patients. Although the SLN biopsy rate increased in both groups between 2002 and 2007, a fixed disparity persisted through the five years.

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