Skip Navigation

JNCI Monographs 2001 2001(30):52-55;
© 2001 by Oxford University Press
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Request Permissions
Google Scholar
Right arrow Articles by Muss, H. B.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Muss, H. B.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Journal of the National Cancer Institute Monographs, No. 30, 52-55, 2001
© 2001 Oxford University Press

Factors Used to Select Adjuvant Therapy of Breast Cancer in the United States: an Overview of Age, Race, and Socioeconomic Status

Hyman B. Muss

Correspondence to: Hyman B. Muss, M.D., University of Vermont College of Medicine, Vermont Cancer Center, University Health Center, St. Joseph 3400, 1 South Prospect St., Burlington, VT 05401 (e-mail: hyman.muss{at}vtmednet.org).

Age, race, and socioeconomic status all play a role in decisions regarding breast cancer adjuvant therapy. Increasing age remains the major risk factor for breast cancer, while in very young women breast cancer may have a poorer prognosis, even when adjusted for disease stage and other variables. More than half of all new breast cancers in the United States occur in women older than 65 years. Because of the higher frequency of coexisting (comorbid) serious illness in older women, the benefits of adjuvant therapy get smaller as age increases. Adjuvant therapy with tamoxifen and/or chemotherapy can statistically significantly improve survival in older women, but older women are less likely to receive chemotherapy and are less likely to be offered participation in clinical trials. Efforts are now under way to overcome age bias among health care providers and to develop clinical trials focusing on older patients. Breast cancer mortality is higher in African-Americans than in white Americans. Although the biologic characteristics of breast cancer are worse in African-Americans, major differences in survival are related to socioeconomic factors and access to care. When matched for disease stage and other major clinical and biologic variables, African-American and white patients have similar survival rates. Few data are available on the effects of adjuvant treatment on early breast cancer outcomes in Hispanic Americans and Asian-Americans. Poverty and lack of insurance are surrogates for poor outcomes; major efforts are needed to guarantee all Americans high-quality cancer care.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.