Researchers from the University of North Carolina at Chapel Hill reported low rates of targeted breast cancer treatments among older women with early-stage breast cancer, especially older black women. Findings from this study are published in the Journal of Clinical Oncology.

The study’s first author, Katherine Reeder-Hayes, MD, MBA, and colleagues followed the use of trastuzumab (Herceptin) in 1,362 women aged ≥66 years who were diagnosed with non-metastatic HER2 positive breast cancer in 2010-2011 and insured by Medicare. Based on claims data, study authors found that black women were 25% less likely to receive the drug within 1 year of diagnosis than white women; this was sustained even after adjusting for other factors that could affect treatment access (eg, poverty, comorbid conditions).

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About half of the women in the study did not receive any trastuzumab and only 50% of white women and 40% of black women received some treatment with trastuzumab. Trastuzumab, a human epidermal growth factor receptor (HER2) inhibitor, has been shown to increase overall survival for HER2-positive breast cancers by 37% when given with post-op chemotherapy. Researchers acknowledged that the study did not account for possible limitations that could affect a woman’s ability to receive trastuzumab such as, the cost of the drug and the long treatment duration that is recommended in combination with chemotherapy. 

Study authors noted, “There was underutilization broadly of what is very effective therapy — we must find out why.” They stressed the importance of recognizing that a merging of the factors they highlighted can serve as a warning sign of the vulnerable patients who are not receiving appropriate care.

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