Black women significantly less likely to undergo SLNB, more likely to have lymphedema
WEDNESDAY, Dec. 5 (HealthDay News) -- Compared with white women, black women with node-negative breast cancer are significantly less likely to receive the less invasive sentinel lymph node biopsy (SLNB) for breast cancer staging, according to a study presented at the annual San Antonio Breast Cancer Symposium, held from Dec. 4 to 8.
Dalliah Mashon Black, M.D., of the University of Texas MD Anderson Cancer Center in Houston, and colleagues used Surveillance, Epidemiology, and End Results Medicare data from 31,274 women (5.7 percent black) aged 66 or older to examine racial differences in the utilization of SLNB in patients with node-negative breast cancer.
The researchers found that 74 percent of white women and 62 percent of black women received an SLNB procedure (P < 0.001). For black and white patients, the use of SLNB increased by year, but the disparity persisted through 2007. After adjustment for tumor size, patient sociodemographics, and type of breast surgery, black patients were 33 percent less likely to undergo SLNB. The five-year cumulative incidence of lymphedema was significantly higher in patients undergoing axial lymph node dissection versus SLNB (11.4 versus 6.3 percent), and black race correlated with a significantly elevated risk of lymphedema (adjusted hazard ratio, 1.40). However, whites and blacks undergoing SLNB had similar risks of lymphedema (6.2 versus 7.7 percent).
"From 2002, when surgeons were still incorporating SLN biopsy into practice, until 2007, black women were less likely to have undergone an SLN biopsy than were white women," Black said in a statement. "The fact that this disparity continued over time shows that new and improved surgical therapies may not be effectively implemented in some patient populations."