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Importance of race on breast cancer survival
G H Lyman1, N M Kuderer, S L Lyman
1Department of Internal Medicine, University of South Florida, Tampa 33612, USA.
Background:
Breast cancer survival has been shown to be significantly less among black women than white women. The reason for this difference in survival is unclear.
Methods:
Data were obtained retrospectively on 439 women seen between 1985 and 1993 based on a detailed chart audit. The impact of race and several known prognostic factors on overall survival, time to relapse, and survival after relapse were studied.
Results:
Black women with breast cancer were found to have a greater risk of recurrence, shorter overall survival, and shorter survival after relapse than did white women. Black patients were found to be younger and have higher stage of disease and lower hormone receptor levels than were white patients. After adjustment for menopausal status and disease stage, a significant independent effect of race was observed on overall survival but not risk of recurrence. In multivariate analysis, a significant interaction was observed between race and age in some models. Survival after recurrence of disease was lower among black than white women after adjustment for menopausal status and estrogen receptor level.
Conclusion:
Black women experience shorter survival times than do white women, including a shorter survival time after disease recurrence. Breast cancer in black women is associated with younger age, higher stage at presentation, and low hormone receptor levels. After adjustment for known prognostic factors, race remains a significant independent predictor of breast cancer survival.