乳腺癌女性在身体和功能领域的种族差异。
Racial disparities in physical and functional domains in women with breast cancer.
机构信息
Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA.
出版信息
Support Care Cancer. 2012 Aug;20(8):1839-47. doi: 10.1007/s00520-011-1285-7. Epub 2011 Oct 7.
INTRODUCTION
African-American women are more likely than white women to have functional impairments after breast cancer (BC) surgery; however, no differences were found in self-reported health status surveys at 12+ months postsurgery.
PURPOSE
This analysis compared white and African-American BC survivors' (BCS) health status, health-related quality of life, and the occurrence of physical impairments after BC treatment.
METHODS
One hundred sixty-six women (130 white, 28 African-American, 8 other) were assessed for impairments preoperatively and at 1, 3, 6, 9, and 12+ months postsurgery. Health status was assessed at 12+ months using the Short Form Health Survey (SF36v2™). Analysis of variance estimated differences between groups for health status and impairment occurrence.
RESULTS
No differences were found between groups for BC type, stage, grade, or tumor size; surgery type; or number of lymph nodes sampled. African-American BCS had more estrogen/progesterone receptor-negative tumors (p < 0.001; p = 0.036) and received radiation more frequently (p = 0.03). More African-American BCS were employed (p = 0.022) and reported higher rates of social activities (p = 0.011) but less recreational activities (p = 0.020) than white BCS. African-American BCS had higher rates of cording (p = 0.013) and lymphedema (p = 0.011) postoperatively. No differences were found in self-reported health status.
CONCLUSION
In a military healthcare system, where access to care is ubiquitous, there were no significant differences in many BC characteristics commonly attributed to race. African-American women had more ER/PR-negative tumors; however, no other BC characteristics differed between racial groups. African-American women exhibited more physical impairments, although their BC treatment only differed regarding radiation therapy. This suggests that African-American BCS may be at higher risk for physical impairments and should be monitored prospectively for early identification and treatment.
介绍
非裔美国女性在乳腺癌（BC）手术后出现功能障碍的可能性高于白人女性；然而，在手术后 12 个月及以上的自我报告健康状况调查中并未发现差异。
目的
本分析比较了白人和非裔美国乳腺癌幸存者（BCS）的健康状况、健康相关生活质量以及乳腺癌治疗后身体损伤的发生情况。
方法
166 名女性（130 名白人，28 名非裔美国人，8 名其他种族）在术前以及术后 1、3、6、9 和 12 个月+进行损伤评估。使用健康调查简表（SF36v2™）在术后 12 个月评估健康状况。方差分析估计了组间健康状况和损伤发生的差异。
结果
在 BC 类型、分期、分级或肿瘤大小、手术类型或取样的淋巴结数量方面，组间均未发现差异。非裔美国 BCS 具有更多的雌激素/孕激素受体阴性肿瘤（p < 0.001；p = 0.036），并且更常接受放疗（p = 0.03）。更多的非裔美国 BCS 就业（p = 0.022），报告更高的社交活动率（p = 0.011），但更少的娱乐活动（p = 0.020），而非白人 BCS。非裔美国 BCS 术后发生排线（p = 0.013）和淋巴水肿（p = 0.011）的比率较高。自我报告的健康状况无差异。
结论
在一个医疗保健系统中，获得医疗服务的机会普遍存在，许多与种族相关的乳腺癌特征在许多方面没有显著差异。非裔美国女性具有更多的 ER/PR 阴性肿瘤；然而，种族群体之间没有其他乳腺癌特征存在差异。非裔美国女性表现出更多的身体损伤，尽管她们的乳腺癌治疗仅在放疗方面有所不同。这表明非裔美国 BCS 可能面临更高的身体损伤风险，应进行前瞻性监测，以便及早发现和治疗。
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