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Lower white blood cell counts in African-American women with early-stage breast cancer can lead to delays in treatment when compared with Caucasian women with the same stage of disease, according to a new study by physician-scientists at Columbia University Medical Center at NewYork-Presbyterian Hospital. The treatment delays may explain racial differences in breast cancer survival, suggest the authors of the study, which appears in the October 15 Journal of the National Cancer Institute.

Dr. Hershman and her colleagues studied 73 African-American and 126 Caucasian women, and of these women, 43 African-American and 93 Caucasian women were treated with chemotherapy. Confirming earlier research, the study found that African-American women had white blood cell counts that are on average 25 to 40 percent lower than those of women of European-American ancestry. The study found that these African-American women required a comparatively longer treatment duration (19 weeks versus 15 weeks). "This difference in dose intensity may contribute to the observed disparities in survival between African-American women and Caucasian women with breast cancer," the researchers report. Research has shown that risk of death for African-American women is 67 percent higher than for Caucasian women (Cancer, Joslyn et al., 2000).

"Despite lower breast cancer incidence, African-American women have a worse prognosis from breast cancer than Caucasian women, even when their cancers are at an equivalent stage," says Dr. Dawn Hershman, assistant professor of medicine at Columbia University College of Physicians & Surgeons and Director of the Breast and Gynecologic Malignancy Clinic at Columbia University Medical Center at NewYork-Presbyterian Hospital. "While the current study is preliminary and small in scale, we have found telling evidence of treatment disparities by race. The reasons for this disparity are probably several, including socioeconomic and biologic. However, our research points to a treatment related factor that affects the duration of chemotherapy administration. Ultimately, this can be corrected."

Dr. Hershman will conduct further research in order to confirm these preliminary findings and track comparative survival rates by race.

Ethnic differences in white blood cell counts has been demonstrated by prior clinical research (Journal of Clinical Pathology, Bain et al., 1996).

The study is supported in part by the Avon Foundation and the Jean Sindab Fund.

Joining Dr. Hershman in the study are Columbia University Medical Center's Dr. Alfred I. Neugut, Dr. Michell Weinberg, Dr. Zachary Rosner, Dr. Karenza Alexis, Dr. Amy Tiersten, Dr. Victor R. Grann, and Dr. Andrea Troxel.