Characteristics and Treatment Modalities for African American Women Diagnosed With Stage III Breast Cancer

BACKGROUND: Stage III breast cancers account for about 6% to 7% of all invasive breast cancers diagnosed annually in the United States. In African American (AA) women, the incidence of stage III breast cancers is almost double that in Caucasian women. The aim of this study was to correlate age, receptor status, nuclear grade, and differences in treatment modalities for stage III breast cancer in an inner-city hospital serving a large AA population. METHODS: A retrospective review was performed for all stage III primary breast cancers diagnosed and or treated from 2000 to 2006. RESULTS: Of 840 primary invasive breast cancers, the authors identified 107 as stage III, 40.2% IIIA, 32.7% IIIB, 16.8% T4D, and 10.3% IIIC. The majority of the patients were AA (n = 93, 86.9%). Stage IIIC patients were younger (P < .05). Triple negative tumors (TNT) accounted for 29.0%. TNT were more likely among the inflammatory breast cancers (50.0%) compared with the other 3 groups (P < .05). Twenty-two patients (20.5%) refused chemotherapy, and 24 of the 91 patients (26.3%) who should have received chest wall radiation refused. There was no difference in race, marital status, religion, or age in the patients that refused chemotherapy or rakation therapy versus the majority of patients in this series who received standard care. CONCLUSIONS: Stage III breast cancers in AA women have distinct clinical characteristics. A high number of these patients refused chemotherapy and radiation therapy. Reasons for refusal need to be better defined so strategies can be implemented to improve compliance for these advanced stage patients. Cancer 2009;115:3009-15. (C) 2009 American Cancer Society.