Roughly one in five African American women with advanced breast cancer refuse chemotherapy and close to one in four refuse radiation therapy, according to a report in the journal Cancer.

Further research is needed to determine why these women refuse recommended treatments so that strategies can be implemented to improve acceptance, Dr. Monica Rizzo, from Emory University, Atlanta, and colleagues state.

About 6 percent to 7 percent of invasive breast cancers diagnosed each year in the US are at an advanced stage (stage III or higher). The distribution by race, however, is not equal: African American women have roughly double the rate of their Caucasian counterparts.

Rizzo and colleagues analyzed data for all women diagnosed with or treated for this disease at one inner-city hospital from 2000 to 2006. Of 107 women with stage III breast cancer identified, 93 (86.9 percent) were in African American women.

Chemotherapy and radiation therapy were refused by 20.4 percent and 23.6 percent of African American women, respectively. Among the relatively few non-African American women identified, the corresponding refusal rates were 21.4 percent and 14.2 percent.

“To overcome this high refusal rate,” the investigators report, “we have implemented a community outreach and internal navigational program” to assure adherence to standard treatment for advanced breast cancer.

“We strongly believe that these prospectively implemented interventions based on this and other studies at our center can significantly improve outcome in these advanced breast cancer patients,” they wrote.

SOURCE: Cancer, July 1, 2009.