PITTSBURGH, Jan. 14 -- Black and white women with same-stage breast cancer see largely similar outcomes when their treatment and follow-up care are appropriate for their individual disease conditions, suggesting that physiological responses to treatments are not responsible for poorer outcomes among blacks. These findings are reported in a review paper by University of Pittsburgh researcher James J. Dignam, Ph.D., and published this week in the January-February issue of CA: A Cancer Journal for Clinicians, a journal of the American Cancer Society.

The review covered historic and recent research on breast cancer prognosis among black and white women, including investigations of clinical, pathologic, social, economic and demographic factors that may contribute to poorer outcomes for blacks.

"Results of this review suggest that treatments for breast cancer have the same results in black women as they do in white women at the same stage of disease when administered according to expert consensus, and that the reasons for blacks' poorer prognoses lie elsewhere," said Dr. Dignam, research assistant professor in the University's Graduate School of Public Health, and biostatistician for the National Surgical Adjuvant Breast and Bowel Project (NSABP).

Dr. Dignam's review shows that the most important determinant of ultimate outcome in breast cancer patients is the stage of cancer at diagnosis, and blacks are more often diagnosed at a more advanced stage than are whites. Dr. Dignam suggested that possible reasons for this late diagnosis may be less access to or utilization of health care resources that would result in earlier detection, or more aggressive forms of the disease among black women.

"The bottom line is, early detection and appropriate follow-up therapy could appreciably reduce the disparity in outcome between black and white breast cancer patients," said Dr. Dignam. "Also, it is imperative that established therapies be uniformly d
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Contact: Kathryn Duda
dudak@msx.upmc.edu
412-624-2607
University of Pittsburgh Medical Center
13-Jan-2000