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Racial disparities in physical and functional domains in women with breast cancer

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Abstract

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.

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Notes

  1. National Institutes of Health (NIH) Protocol 02-CC-0044; National Naval Medical Center (NNMC) Protocol B01-052

  2. Pero-System Messgerate, Am Tescher Busch 9, D-42327, Wuppertal, Germany

  3. Detecto Model CN20, Webb City, MO, USA

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Acknowledgments

This study was supported by the National Naval Medical Center (National Naval Medical Center [NNMC] Protocol NNMC 2001–052) and by the National Institutes of Health (NIH), Clinical Center, Rehabilitation Medicine Department, Physical Therapy Section (Protocol NIH 02-CC-0044).

Author information

Authors and Affiliations

  1. Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA

    Alicia J. Morehead-Gee & Ellen Levy

  2. Physical Therapy Department, University of Michigan-Flint, Flint, MI, USA

    Lucinda Pfalzer

  3. CLM Consulting, Rockville, MD, USA

    Charles McGarvey

  4. Rehabilitation and Reintegration Division, US Army Office of the Surgeon General, Falls Church, VA, USA

    Barbara Springer

  5. Naval Hospital, San Diego, CA, USA

    Peter Soballe

  6. College of Health and Human Services, George Mason University, Fairfax, VA, USA

    Lynn Gerber

  7. National Naval Medical Center, Bethesda, MD, USA

    Nicole L. Stout

  8. Breast Care Center, National Naval Medical Center, 8901 Wisconsin Avenue, Bldg. 19 3rd Floor, Bethesda, MD, 20889, USA

    Nicole L. Stout

Authors
  1. Alicia J. Morehead-Gee
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  2. Lucinda Pfalzer
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  3. Ellen Levy
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  4. Charles McGarvey
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  5. Barbara Springer
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  6. Peter Soballe
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  7. Lynn Gerber
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  8. Nicole L. Stout
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Corresponding author

Correspondence to Nicole L. Stout.

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All authors have read and approved this manuscript.

The views expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the U.S. Government.

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Morehead-Gee, A.J., Pfalzer, L., Levy, E. et al. Racial disparities in physical and functional domains in women with breast cancer. Support Care Cancer 20, 1839–1847 (2012). https://doi.org/10.1007/s00520-011-1285-7

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  • DOI: https://doi.org/10.1007/s00520-011-1285-7

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