Podcast: Breast Cancer Awareness: What you need to know Valorie Burton talks with Dr. Doris Browne, MD Program Director, National Cancer Institute, National Institutes of Health and Dr. Lisa Newman, MD Breast cancer expert, oncological surgeon and assistant professor, University of Michigan
Podcast : Valorie Burton talks with Delores Burgess, Breast Cancer Survivor, North Hollywood, CA
Q. What is the ratio of Black women to white women that have mastectomies in this country, when they are diagnosed with breast cancer? (As opposed to chemo or other treatments)
Kim, 45
A. Hi Kim:
I'd like to preface my response with some general information regarding treatment for breast cancer:
Nearly all breast cancer patients will require surgical treatment for their disease. The two primary types of surgical treatment for breast cancer are mastectomy (complete removal of the entire breast, including the nipple) and lumpectomy (removing only the portion of the breast that contains the cancer; this is frequently called breast conservation therapy).
Lumpectomy for breast cancer should be followed by radiation treatment to the breast, as a strategy to kill any microscopic cancer cells hiding in the surrounding breast tissue. Survival from breast cancer is equivalent (the same) following either of these treatment approaches.
Whether or not a patient is eligible for lumpectomy depends on the size and pattern of breast cancer, and whether or not the patient is able to receive radiation therapy. For those women that require mastectomy, breast reconstruction by the plastic surgeon is a terrific option.
Many breast cancer patients will require non-surgical treatment such as chemotherapy and/or endocrine therapy (special cancer-fighting pills) in addition to surgery. The non-surgical treatments are called systemic therapy, and these treatments are absorbed into the bloodstream so that they can circulate throughout the body and kill cancer cells that are hiding in other organs. Systemic therapy is extremely important because death from breast cancer is usually caused by spread of the cancer to other organs in the body, such as the liver, lungs, bones, and/or brain. Decisions regarding the need for systemic therapy for individual patients are made on the basis of the cancer stage (size of the cancer and whether or not it has spread to the glands, or lymph nodes of the underarm area) and the tumor type.
It is very important for every breast cancer patient to understand that her choice of breast conservation therapy (lumpectomy and radiation therapy) versus mastectomy will NOT affect decisions regarding whether or not systemic therapy/chemotherapy is necessary.
That said, the following patterns have been reported regarding disparities in breast cancer treatment for African American compared to White American patients:
- Most studies demonstrate that rates of lumpectomy versus mastectomy are similar for African American and White American breast cancer patients.
- Several studies have unfortunately shown that African American women undergoing lumpectomy are less likely to receive radiation therapy after the lumpectomy. This is very important, because failure to receive radiation therapy leads to an increased likelihood that the cancer will grow back in the breast.
- Recent studies have shown that African American women undergoing mastectomy are less likely to undergo breast reconstruction.
- Some studies have shown that African American women are less likely to receive complete or adequate doses of necessary chemotherapy.
Take care,
Lisa A. Newman, MD, MPH, FACS
Director, Breast Care Center
University of Michigan Comprehensive Cancer Center
