Summary
African-American (AA) women with breast cancer have higher mortality rates than Caucasian woman, and some studies have suggested that this disparity may be partly explained by unequal access to medical care. The purpose of this study was to analyze racial differences in patterns and costs of care and survival among women treated for invasive breast cancer at a large academic medical center. Subjects included 331 AA and 257 Caucasian women diagnosed with stage I–III breast cancer between 1994 and 1997. Clinical, socio-demographic, and cost data were obtained from the medical record, cancer registry, and hospital financial database. Data were collected on the use of cancer directed treatments (surgery, radiation, chemo and hormonal therapy) up to 1-year post-diagnosis. Survival analyses compared disease-free and overall survival by race adjusting for age, stage, nodal involvement, ER/PR status and a diagnosis of hypertension, diabetes, heart disease and cerebral vascular accident. There were no significant racial differences in treatment utilization and costs. The mean total 1-year treatment costs were $16,348 for AAs and $15,120 for Caucasians. While AAs had a significantly higher unadjusted relative risk (RR) of recurrence 2.09 (95% CI: 1.41–3.10) and death 1.56 (95% CI: 1.09–2.25), the multivariate adjusted analyses resulted in no significant differences in recurrence 1.38 (95% CI: 0.85–2.26) or death 1.06 (95% CI: 0.64–1.75). There was no obvious racial disparity in treatment and costs noted. Our findings support the theory that equal treatments produce equal outcomes. Improvement in screening may have an important impact on survival among minority women with breast cancer.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
HK Weir MJ Thun BF Hankey LA Ries HL Howe PA Wingo et al. (2003) ArticleTitleAnnual report to the nation on the status of cancer, 1975–2000, featuring the uses of surveillance data for cancer prevention and control J Natl Cancer Inst 95 IssueID17 1276–1299 Occurrence Handle12953083
MJ Edwards JW Gamel WP Vaughan WR Wrightson (1998) ArticleTitleInfiltrating ductal carcinoma of the breast: the survival impact of race J Clin Oncol 16 IssueID8 2693–2699 Occurrence Handle1:STN:280:DyaK1czmvVCitQ%3D%3D Occurrence Handle9704719
MS Simon RK Severson (1996) ArticleTitleRacial differences in survival of female breast cancer in the Detroit metropolitan area Cancer 77 IssueID2 308–314 Occurrence Handle10.1002/(SICI)1097-0142(19960115)77:2<308::AID-CNCR13>3.3.CO;2-V Occurrence Handle1:STN:280:BymB38zjs1w%3D Occurrence Handle8625239
CD O’Malley GM Le SL Glaser SJ Shema DW West (2003) ArticleTitleSocioeconomic status and breast carcinoma survival in four racial/ethnic groups: a population-based study Cancer 97 IssueID5 1303–1311 Occurrence Handle10.1002/cncr.11160 Occurrence Handle12599239
LX Clegg FP Li BF Hankey K Chu BK Edwards (2002) ArticleTitleCancer survival among US whites and minorities: a SEER (Surveillance, Epidemiology, and End Results) Program population-based study Arch Intern Med 162 IssueID17 1985–1993 Occurrence Handle10.1001/archinte.162.17.1985 Occurrence Handle12230422
VL Shavers LC Harlan JL Stevens (2003) ArticleTitleRacial/ethnic variation in clinical presentation, treatment, and survival among breast cancer patients under age 35 Cancer 97 IssueID1 134–147 Occurrence Handle10.1002/cncr.11051 Occurrence Handle12491515
SA Joslyn (2002) ArticleTitleRacial differences in treatment and survival from early-stage breast carcinoma Cancer 95 IssueID8 1759–1766 Occurrence Handle10.1002/cncr.10827 Occurrence Handle12365025
KC Chu CA Lamar HP Freeman (2003) ArticleTitleRacial disparities in breast carcinoma survival rates: separating factors that affect diagnosis from factors that affect treatment Cancer 97 IssueID11 2853–2860 Occurrence Handle10.1002/cncr.11411 Occurrence Handle12767100
SA Joslyn (2002) ArticleTitleHormone receptors in breast cancer: racial differences in distribution and survival Breast Cancer Res Treat 73 IssueID1 45–59 Occurrence Handle10.1023/A:1015220420400 Occurrence Handle1:CAS:528:DC%2BD38XksFehsbw%3D Occurrence Handle12083631
CI Li KE Malone JR Daling (2003) ArticleTitleDifferences in breast cancer stage, treatment, and survival by race and ethnicity Arch Intern Med 163 IssueID1 49–56 Occurrence Handle10.1001/archinte.163.1.49 Occurrence Handle12523916
BE Wojcik MK Spinks CR Stein (2003) ArticleTitleEffects of screening mammography on the comparative survival rates of African American, white, and Hispanic beneficiaries of a comprehensive health care system Breast J 9 IssueID3 175–183 Occurrence Handle10.1046/j.1524-4741.2003.09308.x Occurrence Handle12752625
I Jatoi H Becher CR Leake (2003) ArticleTitleWidening disparity in survival between white and African-American patients with breast carcinoma treated in the U. S. Department of Defense Healthcare system Cancer 98 IssueID5 894–899 Occurrence Handle10.1002/cncr.11604 Occurrence Handle12942554
AT Mancino IT Rubio R Henry-Tillman LF Smith R Landes HJ Spencer et al. (2001) ArticleTitleRacial differences in breast cancer survival: the effect of residual disease J Surg Res 100 IssueID2 161–165 Occurrence Handle10.1006/jsre.2001.6232 Occurrence Handle1:STN:280:DC%2BD3Mrks1Wrug%3D%3D Occurrence Handle11592786
MS Simon RK Severson (1997) ArticleTitleRacial differences in breast cancer survival: the interaction of socioeconomic status and tumor biology Am J Obstet Gynecol 176 IssueID6 S233–S239 Occurrence Handle1:STN:280:ByiA2MfgslU%3D Occurrence Handle9215214
VL Shavers ML Brown (2002) ArticleTitleRacial and ethnic disparities in the receipt of cancer treatment J Natl Cancer Inst 94 IssueID5 334–357 Occurrence Handle11880473
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Du, W., Simon, M.S. Racial disparities in treatment and survival of women with stage I–III breast cancer at a large academic medical center in metropolitan Detroit. Breast Cancer Res Treat 91, 243–248 (2005). https://doi.org/10.1007/s10549-005-0324-9
Issue Date:
DOI: https://doi.org/10.1007/s10549-005-0324-9