Reply
Tue 6 Jun, 2006 08:56 pm
Older black women do not receive preferred breast cancer treatment.
Data from 984 black and 849 white Medicare-insured women aged 67 years or older who had localized breast cancer were analyzed, and a subset of 732 surviving women were interviewed 3 to 4 years after treatment. Black women were 36 percent more likely than white women to receive mastectomy versus breast-conserving surgery and radiation. Further, when black women received BCS, they were 48 percent more likely than white women to not have radiotherapy.
Mandelblatt, Kerner, Hadley, et al., Cancer 95:1401-1414, 2002 (AHRQ grant HS08395).
So, what do you think it means?
Well, off hand, whether you get lumpo or masto depends somewhat on the stage at which your cancer was identified. On radiation, I am not all so smart on that, if they still do radio for those needing high level of chemo.
It may be true that older black women are discounted. Might even be true that older white women are discounted.
On discounting, Miller, that didn't happen in any of the clinical circumstances I was around, back in my clin research lab days, but I don't deny that it may be going on somewhere.
The incidence of breast cancer in black women is about twice that found in white women. This may be due to the unique presence of an aggressive form of breast cancer in black women, and the fact that breast cancer often isn't detected at an early stage in black women.
Another factor to consider is the treatment afforded to these women. For instance, do black women in the rural South, have the same modalities of treatment as do women, for instance in New York city, at Sloan-Kettering?
Let me guess that Sloan-Kettering equivalency is not all so common, though a number of other places are right up there in the fray to understand and conquer the disease and help those with it.
It might be true, what the link said, that black women are prone to get a particularly fast breast CA type. I (and my doc) worried about that myself (I'm white), in that my biopsy showed a minute bit of CA and my later surg specimen was quite far from that site... all still stage I. I seem to be clear at five years, but some smallies are speedy, and maybe more black women have them for whatever reason.
Delay in care, both in getting to it and once patients get there, is a likely factor too.
That sounds scary as far as I understand....here, BCS + radio is automatic, unless a woman refuses, because it is the combination that brings the stats up to the level of efficacy of mastectomy.
There are all kinds of stats that show blacks in general - all else being equal (insurance and other societal/class factors) - routinely receive less in depth medical treatment than whites in general. That's just fact in the good ole USA.
Not arguing on that, Snood.
There just seems to be a lot of equivocating about the central point of the launch post. "It may happen, but not in my clinic" "It may be true that they receive hasty treatment" etc.
So, I thought I'd state that it IS true, overall, generally speaking.
And, therein, is a reason for increasing the number of qualified black medical students and eventually MDs.