Racial disparities in physical and functional domains in women with breast cancer
Menée aux Etats-Unis auprès de 166 participantes, cette étude analyse les disparités ethniques dans la qualité de vie et les symptômes et déficiences physiques de patientes atteintes d'un cancer du sein après leur traitement chirurgical
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.