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Is race a poor prognostic factor in breast cancer?
M B El-Tamer1, P Homel, R B Wait
1State University of New York, Health Science Center at Brooklyn, USA.
Journal of the American College of Surgeons
|July 13, 1999
Summary
African American women with breast cancer have poorer survival rates, but race is not an independent prognostic factor. Advanced stage at diagnosis and younger age contribute to this disparity, highlighting the need for early screening.
Area of Science:
- Oncology
- Epidemiology
- Health Disparities
Background:
- African American women exhibit higher breast cancer mortality rates compared to Caucasian women.
- Investigating the role of race as an independent prognostic factor in breast cancer survival is crucial.
Purpose of the Study:
- To determine if race is a significant prognostic factor in breast cancer survival.
- To analyze survival rates after accounting for multiple prognostic variables.
Main Methods:
- Retrospective analysis of tumor registry data from 1,745 patients (1982-1995).
- Inclusion of African American (1,297) and Caucasian (448) women.
- Evaluation of race, age, income, stage, histology, operation type, and institution as prognostic variables using Cox regression analysis.
Main Results:
- Univariate analysis indicated African American patients were 1.27 times more likely to die from breast cancer (p=0.01).
- Multivariate analysis revealed stage at diagnosis, age, and therapeutic surgical treatment as significant prognostic factors.
- Race, income, hospital, and histologic findings were not significant in the multivariate model.
Conclusions:
- The disparity in breast cancer survival for African American women is linked to advanced stage at diagnosis and younger age.
- Targeted screening initiatives for early detection in younger African American women are recommended.
- Improving survival necessitates addressing socioeconomic and healthcare access factors contributing to late-stage diagnosis.