Results of treatment of Stage I-III breast cancer in black Americans: the Cook County Hospital experience, 1973-1987
Article Abstract:
There is no question that the survival rate for black women with breast cancer is less than that for white women. However, whether the prognosis for breast cancer in black women is actually worse remains a point of controversy. This is because black women tend to have more advanced disease at the time of diagnosis; however, it is uncertain if the delayed diagnosis among black women accounts for all the difference in survival rates. To examine this question, the treatment and survival of 526 black women over a 15-year period were reviewed. For early-stage disease, that is, cancer that has not progressed to the lymph nodes, the 5- and 10-year survival was projected to be 83.9 and 79.6 percent, respectively. For patients with positive nodes who did not receive adjuvant treatment, the 5- and 10-year survival projected rates were 58.1 and 35.2 percent, respectively. The review also confirmed the value of adjuvant therapy for patients with positive nodes, and found that the benefit was greatest for patients over 50. Estrogen and progesterone receptors were measured, and there were no apparent differences from the white population. This is in contrast to some other studies, in which the incidence of breast cancers with estrogen receptors was found to be reduced among black women. Overall, the present study found no difference in the natural history of breast cancer in black women. Since it is well documented that breast cancer is less common among black women, it would be difficult to assert that no difference in the natural history of the disease exists. However, it seems that whatever differences might exist have little effect on response to treatment or survival. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Cancer
Subject: Health
ISSN: 0008-543X
Year: 1990
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Dukes' classification revisited: finding from the National Surgical Adjuvant Breast and Bowel Projects (protocol R-01)
Article Abstract:
Cancer staging takes into account the type of cancer cell, how far it has invaded the local tissues, the amount of lymph nodes involved and the degree of cancer spread (metastasis). This information can be used to predict disease prognosis and determine treatment modalities. The Dukes' classification system is used to stage cancers of the colon and rectum. However, there is some variability and confusion regarding the criteria used for staging. The relative prognostic value of using this type of classification system was compared to TNM (tumor, nodes and metastasis) and Astler and Coller staging systems, a method which subdivides the staging further. The three systems were used to evaluate 745 patients with rectal cancer. All the systems were interrelated and provided sufficient information for predicting the prognosis of colorectal cancer. However, TNM did not provide any additional value over the Dukes method. The Dukes' method of colorectal cancer staging is the simplest method of determining disease prognosis. The incorporation of the C staging of the Coller method would enhance the value of this tool. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Cancer
Subject: Health
ISSN: 0008-543X
Year: 1989
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