Division of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center, 1200 Herman Pressler Dr, Houston, TX 77030, USA.
Med Oncol. 2013 Mar;30(1):419. doi: 10.1007/s12032-012-0419-1. Epub 2013 Jan 6.
While large differences by race/ethnicity in breast cancer survival are well established, it is unknown whether differences in quality of chemotherapy delivered explain the racial/ethnic disparities in survival among black, Hispanic, Asian, and white women with breast cancer. We evaluated factors associated with time to initiation of adjuvant chemotherapy and chemotherapy completion and examined outcomes data among women with breast cancer. Patients who initiated chemotherapy later than 3 months after surgery were 1.8 times more likely to die of breast cancer (95 % CI 1.3-2.5) compared with those who initiated chemotherapy less than a month after surgery, even after controlling for known confounders or controlling for race/ethnicity. Women who completed chemotherapy had significantly higher survival compared with those who have not completed chemotherapy. Despite correcting for chemotherapy initiation and completion and known predictors of outcome, African American women still had worse disease-specific survival than their Caucasian counterparts. While a complete and timely adjuvant treatment among various ethnic populations would help to reduce racial disparities in survival, there are still other factors to be identified that may explain the remaining differences in survival between ethnic women with breast cancer.
虽然种族/民族之间乳腺癌生存率的巨大差异已得到充分证实，但尚不清楚接受化疗的质量差异是否可以解释黑种人、西班牙裔、亚洲裔和白种乳腺癌女性在生存率方面的种族/民族差异。我们评估了与辅助化疗开始时间和化疗完成时间相关的因素，并检查了乳腺癌患者的结局数据。与术后不到一个月开始化疗的患者相比，术后 3 个月后才开始化疗的患者死于乳腺癌的风险高 1.8 倍（95%CI1.3-2.5），即使在控制了已知混杂因素或控制了种族/民族后也是如此。完成化疗的女性与未完成化疗的女性相比，生存率显著提高。尽管对化疗开始和完成情况以及结局的已知预测因素进行了校正，非洲裔美国女性的疾病特异性生存率仍比白种人差。虽然在不同种族人群中进行完整和及时的辅助治疗有助于减少生存方面的种族差异，但仍需要确定其他可能解释乳腺癌不同族裔女性之间剩余生存差异的因素。
