The study: Researchers looked at differences in the use of radiation therapy after lumpectomy (removal of the tumor and a small, cancer-free area around the tumor) for white and black women. Using a national Medicare database, researchers analyzed the treatment for 34,024 white women and 2,305 black women age 66 or older who were treated with lumpectomy in 2003 for newly diagnosed early-stage breast cancer. Although earlier studies have shown racial disparities in breast cancer treatment, this study is the first to look at the use of radiation therapy after lumpectomy on a national scale and compare geographical regions. The standard treatment for most early-stage invasive breast cancer is lumpectomy followed by radiation therapy. However, a small number of women who may not be able to tolerate treatment may not have radiation therapy.

The results: Black women were less likely to receive radiation therapy after lumpectomy than white women. Overall, only 65% of black women received radiation therapy after lumpectomy compared with 74% of white women. Among women younger than 70, who are more likely to receive standard treatment, 71% of black women received radiation therapy after lumpectomy compared with 81% of white women.

The following regions showed the greatest difference in the use of radiation therapy after lumpectomy:

• East South Central region (AL, KY, MS, TN): 57% of black women compared with 72% of white women
• Pacific West (CA, OR, WA): 55% of black women compared with 72% of white women
• New England (CT, ME, MA, NH, NJ, NY, VT): 58% of black women compared with 70% of white women

The regions with the smallest difference in treatment were the Mountain West (AZ, CO, ID, MT, NV, NM, UT, WY), where 74% of black women received radiation therapy after lumpectomy compared with 76% of white women, and the West North Central Midwest (IA, KS, MN, MO, NE, ND, SD), where 72% of black women and 74% of white women received radiation therapy after lumpectomy.

What this means for patients

“The results of this study indicate that we need to identify and correct the obstacles that are causing these disparities, and work to increase awareness about the benefits of radiation therapy after lumpectomy among patients with breast cancer,” said lead author Grace Smith, MD, PhD, MPH, Postdoctoral Fellow in the Department of Radiation Oncology at the University of Texas M.D. Anderson Cancer Center. “We don't know if fewer black women are receiving radiation therapy because it is not offered to them, because they decline the treatment, or because they are unable to complete treatment.” Before making a treatment decision, talk with your doctor about all the treatment options available to you, including the benefits, risks, and possible side effects.