Local recurrence and survival among black women with early-stage breast cancer treated with breast-conservation therapy or mastectomy

Background: Black women with breast cancer have significantly worse surviva l rates and receive diagnoses at relatively younger ages, compared with whi te patients with breast cancer, in the United States. Young age at diagnosi s has been associated with increased risk for local recurrence (LR) after b reast-conservation therapy (BCT). The goal of this study was to evaluate th e impact of age and BCT on LR and survival rates among black patients with breast cancer. Methods: The records for 363 black women treated for breast cancer (excludi ng stage IV disease) at a comprehensive cancer center were reviewed. Results: Fifty-eight percent of patients (n = 211) had tumors less than or equal to 5 cm in diameter. Forty-two of these patients (19.9%) received BCT ; the LR rate for this group was 9.8%. A total of 168 patients (79.6%) unde rwent mastectomy; the LR rate for this group was 8.9%. Data on the primary operation were unavailable for one patient. Five-year disease-free survival rates were similar for patients treated with BCT and those treated with ma stectomy (88% and 73%, respectively). LR was associated with significant de creases in 5-year overall survival rates for both the BCT group (67% vs. 95 %, P < .01) and the mastectomy group (43% vs. 76%, P < .01). LR and 5-year disease-specific survival rates were similar for patients <50 years of age and patients greater than or equal to 50 years of age, regardless of treatm ent. Conclusions: LR and survival rates are not compromised by the use of BCT am ong black American patients. LR is associated with an increased risk of bre ast cancer death, regardless of treatment type. Younger age at diagnosis wa s not associated with an increased rate of LR after BCT in this series.