Multi-institutional experience of ductal carcinoma in situ in black vs white patients treated with breast-conserving surgery and whole breast radiation therapy
International Journal of Radiation Oncology Biology Physics
Purpose: Given the paucity of data on racial disparities in ductal carcinoma in situ (DCIS), the data from a multi-institutional cohort of DCIS patients treated with breast-conserving surgery and whole breast radiation therapy (RT) were analyzed to determine whether racial disparities or differences exist. Methods and Materials: A total of 533 white and 76 black DCIS patients from 3 university-based cancer centers were uniformly treated with breast-conserving surgery and RT. All patient data were collected and analyzed as a function of race. Results: The median follow-up was 5.2 years. No significant racial differences were seen in tumor size, age at diagnosis, estrogen receptor status, necrosis, or grade (all P>.05). Of the treatment parameters, the RT dose delivered, boost, positive margin rates, frequency of hormone receptor status assessment, and receipt of hormonal therapy for the 2 cohorts did not significantly differ (all P>.05). The local relapse-free survival was similar at 5 years (96.1% and 98.1%, P=.399) and 10 years (92.8% vs 95.8%, P=.360), with no significant overall survival difference at 10 years (94.0% vs 88.9%, P=.290) between the white and black patients, respectively. On multivariate analysis, race was not an independent predictor of local relapse-free survival or overall survival when accounting for age, grade, and margin status. Conclusion: In our large cohort of DCIS patients uniformly treated at 3 institutions with breast conservation without any apparent differences in treatment delivery parameters, we demonstrated that the clinical and pathologic features and local survival outcomes did not differ as a function of race. Our results suggest that when black patients with DCIS are appropriately selected for breast conservation and receive adjuvant RT without racial disparities in the treatment parameters, differences in the outcomes as a function of race do not exist. © 2012 Elsevier Inc.
Nelson, C., Bai, H., Neboori, H., Takita, C., Motwani, S., Wright, J., Hobeika, G., Haffty, B., Jones, T., Goyal, S., & Moran, M. (2012). Multi-institutional experience of ductal carcinoma in situ in black vs white patients treated with breast-conserving surgery and whole breast radiation therapy. International Journal of Radiation Oncology Biology Physics, 84 (3). http://dx.doi.org/10.1016/j.ijrobp.2012.03.068