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.