Since the mid-2000s, sentinel node (SNL)
biopsy before chemo has been the standard of care for all women with breast cancer,
replacing the more invasive axillary lymph node dissection (ALND). This standard has not reached all pockets of our population: Black women have a disproportionately higher rate of
ALND—12 percent—and are suffering the consequences.
Black women who had ALND had a 50 percent
higher rate of lymphedema than those who had SNL. In fact, black and white women with SNL had
similar rates of lymphedema (8.8 percent and 6.8 percent, respectively).
The disparity in treatment between white and black patients persisted despite adjustment
for tumor size, patient sociodemographics, and type of breast surgery.
These results were presented at
the 35th annual San Antonio
Breast Cancer Symposium by Dalliah Mashon Black, M.D., assistant
professor of surgery in the department of surgical oncology at The University
of Texas MD Anderson Cancer Center in Houston.
“These findings are an example of the need for continued
improvements in disseminating national practice guidelines for breast cancer to
surgeons and other breast cancer providers in all of our communities," Dr. Black said.
And all of us who have had more recent treatments that included SNL and were
able to avoid ALND have cause to be thankful.
Our chances of lymphedema, no matter our race, have been cut in half.
Read more about TNBC in my book, Surviving Triple-Negative Breast Cancer.
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