Breast conservation is an effective option in Black, medically indigent patients

The purpose of the study was to evaluate the efficacy of lumpectomy and postoperative radiotherapy in an African-American, medically indigent population. From 1980 through 1996, a retrospective chart review was undertaken of the patients treated with radiotherapy after lumpectomy at an inner city hospital, whose patients are primarily African American and uninsured. One hundred and one patients were treated with breast conservation during this time. Of those, 72 were African American and with invasive carcinoma. The data were analyzed using JMP IN (SAS Institute). The study found that African-American patients with invasive carcinoma had 95.2% local control at 5 years and 87.9% at 10 years. The disease-free survival was 84.6% at 5 years and 65.3% at 10 years. Patients that received less than 50 Gray to the tumor bed had inferior local control, disease-free survival, and overall survival (p < 0.0001 for all three). The 5-year and 10-year local control for DCIS, in a limited number of patients, was 95.2%. We conclude that lumpectomy followed by radiotherapy is an effective treatment strategy in the high-risk population of African-American, medically indigent patients. The local control and disease-free survival compare favorably to published controls in this traditionally high-risk patient population.