Chemotherapy nonadherence higher among black women with breast cancer

Issue: June 25, 2016

Nonadherence to chemotherapy appeared higher among black women with breast cancer than historically observed in community data with predominantly white patients, according to the results of a secondary analysis of a randomized trial presented at the Oncology Nursing Society Annual Congress.

Five-year survival among black patients with breast cancer is 13% lower than that experienced by their white counterparts. Because this disparity cannot be explained entirely by disease stage at diagnosis, Margaret Rosenzweig, PhD, FNP, AOCNP, FAAN, professor of acute and tertiary care in the School of Nursing at University of Pittsburgh, and colleagues sought to compare chemotherapy nonadherence rates among black and white women with breast cancer.

Margaret Rosenzweig

“I think the inability to receive full dose of therapy is some percentage of the survival disparity between white and black women, but I think there are other factors as well,” Rosenzweig told HemOnc Today.

Researchers evaluated data from a clinical trial in which 141 black women with early-stage breast cancer from western Pennsylvania and eastern Ohio were recommended to receive first-time chemotherapy. The intervention arm consisted of a one-time encouragement to begin chemotherapy.

Forty-four percent (n = 61) of women reported annual household income below $30,000.

All women in the analysis began chemotherapy; however, 70 women (49%) had a chemotherapy delay or dose reduction and 71 patients (50%) had some reduction in dose intensity.

Although 82.3% of women received prescribed chemotherapy by the projected end date, 29% (n = 40) received a cumulative dose of less than 80% of the prescribed amount.

Historically, 3.5% to 15% of women with early-stage breast cancer — based on community data, which is predominantly from white patients — receive a relative dose intensity of less than 85%.

“We need a better approach for assessing and treating the symptom distress that occurs with African American women so that they can get full dose therapy,” Rosenzweig said. “I want to do a comparison of white and black women with early-stage breast cancer, all receiving chemotherapy, and do in-depth symptom assessment to observe how those symptoms are being discussed with their physicians and see how the symptoms are being managed.”– by Nick Andrews

Reference:

Rosenzweig M and Connolly M. Presented at: ONS Annual Congress; April 28-May 1, 2016; San Antonio, Texas.

Disclosure : The study was funded by the American Cancer Society and the ACTS Intervention to Reduce Breast Cancer Treatment Disparity.