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Breast Cancer Racial Gap Worse for Later Stage Cancer

Worse outcomes for black women; survival disparity most pronounced in advanced stages of disease

MONDAY, Aug. 13 (HealthDay News) -- Black women have higher mortality rates and shortened survival in breast cancer compared to whites, and these differences are not explained by differences in tumor size and lymph node status, according to study findings published online Aug. 13 in Cancer.

Russell McBride, M.P.H., of the Mailman School of Public Health in New York City, and colleagues analyzed data from 256,174 women with breast cancer (8.5 percent black and 91.5 percent white) from a U.S. National Cancer Institute database. The researchers calculated differences in mortality by race, adjusting for age at diagnosis, stage, tumor size, number of positive lymph nodes, and clinical and demographic characteristics.

Within each stage, blacks had larger tumors than whites. Adjusting for tumor size, black women were more likely to have positive lymph nodes. However, adjustment for within-stage differences in tumor size and lymph nodes showed a negligible effect on survival. After controlling for clinical and demographic factors affecting prognosis, black women had a 39 percent higher morality rate than white women, and racial disparities increased with higher stages of disease.

"Our finding that the racial survival disparity increased with greater stage of disease was unexpected. If this latter finding is confirmed, efforts aimed at reducing racial disparities should focus on eliminating barriers to quality care in black women with higher-stage disease," the authors conclude.

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