IMPORTANCE OF RACE ON BREAST-CANCER SURVIVAL

Background: Breast cancer survival has been shown to be significantly less among black women than white women. The reason for this differenc e in survival is unclear, Methods: Data were obtained retrospectively on 439 women seen between 1985 and 1993 based on a detailed chart audi t. The impact of race and several known prognostic factors on overall survival, time to relapse, and survival after relapse were studied, Re sults: Black women with breast cancer were found to have a greater ris k 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 tha n were white patients. After adjustment for menopausal status and dise ase stage, a significant independent effect of race was observed on ov erall survival but not risk of recurrence. In multivariate analysis, a significant interaction was observed between race and age in some mod els. Survival after recurrence of disease was lower among black than w hite women after adjustment for menopausal status and estrogen recepto r level, Conclusion: Black women experience shorter survival times tha n do white women, including a shorter survival time after disease recu rrence, Breast cancer in black women is associated with younger age, h igher stage at presentation, and low hormone receptor levels. After ad justment for known prognostic factors, race remains a significant inde pendent predictor of breast cancer survival.