Ethnic Differences in Breast Cancer Treatments, Outcomes

SEATTLE—A Fred Hutchinson Cancer Research Center study documents important disparities in breast cancer diagnosis, treatment, and survival among American women of various ethnicities. The findings by Christopher Li, MD, PhD, and his colleagues (Arch Intern Med 163:49-56, 2003) are based on data from 11 tumor registries participating in the Surveillance, Epidemiology, and End Results (SEER) program, including 124,934 women diagnosed with first primary invasive breast cancer from 1992 to 1998.

The analysis showed that blacks, American Indians, Hawaiians, Indians and Pakistanis, Mexicans, South and Central Americans, and Puerto Ricans had a 1.4- to 3.6-fold greater risk of presenting with stage IV breast cancer, relative to non-Hispanic whites. Blacks, Mexicans, and Puerto Ricans were 20% to 50% more likely to receive a first course of surgical and radiation therapy that did not meet the 2000 National Comprehensive Cancer Network (NCCN) guidelines. Blacks, American Indians, Hawaiians, Vietnamese, Mexicans, South and Central Americans, and Puerto Ricans had a 20% to 200% greater mortality risk after a breast cancer diagnosis.