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Illustration 1. One study found that black patients had a higher risk of lymphedema than white patients did

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Scientists gathered to present their latest research findings about breast cancer at the 2012 CTRC-AACR San Antonio Breast Cancer Symposium in December. Jointly sponsored by the Cancer Therapy & Research Center (CTRC) at the University of Texas Health Science Center at San Antonio, the American Association for Cancer Research (AACR), and Baylor College of Medicine in Houston, Texas, the scientific meeting included the following studies, among others:

1. Black women with breast cancer were 12% less likely than white women to undergo a more minimally invasive procedure for staging. Dalliah Mashon Black, MD, assistant professor of surgery in the department of medical oncology at The University of Texas MD Anderson Cancer Center in Houston, presented the data, which were compiled from ther Surveillance, Epidemiology and End Results (SEER)-Medicare database. She and colleagues evaluated whether there was a difference in the use of axillary sentinel lymph node (SLN) biopsy in black patients versus white patients, and whether the difference affected the risk for lymphedema, which can occur after axillary surgery.

The study found that of 31,274 women identified, black patients were 33% less likely than whites to undergo SLN. Overall, black patients also were associated with a higher risk of lymphedema. However, among patients who underwent SLN, white and black women had similar risks of lymphedema.

2. Women with ER-positive breast cancer who received 10 years of adjuvant treatment with tamoxifen received greater protection against late recurrence and death from the disease than women who underwent the current standard of 5 years. The results, from the international Adjuvant Tamoxifen–Longer Against Shorter (ATLAS) study, were presented by Christina Davies, MD, a coordinator in the Clinical Trial Service Unit at the University of Oxford in the United Kingdom. She noted that continuing tamoxifen treatment for 10 years is even better than 5 years, approximately halving breast cancer mortality during the second decade after diagnosis.

Investigators enrolled 6846 women with estrogen receptor (ER)-positive breast cancer between 1996 and 2005. Half the women had node-positive disease, and all of them had been taking tamoxifen for 5 years. They were randomly assigned to continue treatment for another 5 years or to stop immediately. Although the length of treatment did not affect recurrence or death rates in the first 5 to 9 years after diagnosis, it did have an impact in the second decade: Women who continued tamoxifen treatment had a 25% lower recurrence rate and a 29% lower breast cancer mortality rate than women who stopped after 5 years. The risk of death from breast cancer 5 to 14 years after diagnosis was 12.2% among those who continued tamoxifen treatment versus 15% among those who stopped. The greatest benefit was observed 10 to 14 years after diagnosis.