Increased incidence of loco-regional recurrences among African American women with terminal stage breast cancer.

A73

An IRB-approved prospective analysis of all women with terminal stage breast cancer admitted to Community Hospice Northeast (CHNE) from December 2006 through August 2007, was performed in order to evaluate the suggestion from anecdotal observations that AA women with terminal stage breast cancer enrolled in CHNE were more likely to have evidence of loco-regional recurrences as compared with Caucasian women. Terminal stage breast cancer women admitted to CHNE, a not-for-profit hospice that serves over 90% of all hospice patients from Northeast Florida, were eligible for study participation. Hospice nurses assessed the patients for the presence of loco-regional recurrences by performing a chest wall examination. A total of 134 women with terminal stage breast cancer were evaluated. Eighty percent of them (107 patients) were Caucasian, 17% (23 patients) were AA and 3% (4 patients) were of other ethnicities. Evidence of loco-regional recurrences were noted in 13% of the women (17/134 patients). The incidence of loco-regional recurrences was higher in AA women than in Caucasian women (26% vs 10%, 6/23 patients vs 11/107 patients respectively), though this was not statistically significant (p=0.08, Fisher's exact test). The majority of Caucasian women with loco-regional recurrences consented to a review of their medical records whereas only a minority of the AA women consented (72% vs 33%, 8/11 patients vs 2/6 patients respectively).
 Conclusions: Evaluation of disparities in outcomes of breast cancer care in a given community is possible by analyzing data from patients served by a hospice program that cares for the majority of the patients within that community. AA women with breast cancer seem to have a higher incidence of loco-regional failure as a component of their terminal breast cancer disease when compared with Caucasian women. A smaller proportion of AA patients and their families agreed to participate in a medical record review study as compared with Caucasian families. Further studies are indicated in order to elucidate the main factors contributing to these disparities and to formulate potential solutions.