Breast carcinoma tumor characteristics in black and white women

BACKGROUND. A significant disparity in mortality rates exists between black and white patients with breast carcinoma. This study was designed to compa re breast carcinoma tumor characteristics by race and to examine the possib le reasons for these differences. METHODS, Female patients with an initial diagnosis of breast carcinoma betw een January 1, 1985 and December 31, 1993 were selected from the Yale-New H aven Hospital Tumor Registry for this retrospective cohort study. All black patients were eligible and white patients were selected randomly and match ed to each black patient by year of diagnosis. Data were gathered from mult iple sources including the hospital, the Connecticut Tumor Registry, and th e U. S. Census. All pathology specimens were reviewed at Yale-New Haven Hos pital. RESULTS, The final cohort had 100 black and 300 white patients. The black p atients tended to be younger than white patients at the time of diagnosis ( mean age 55 pears vs. 60 years; P = 0.001). A significant racial difference was noted in eight tumor characteristics: stage, size of the tumor, lymph node status, presence of necrosis, vascular/lymphatic invasion, ductal carc inoma in situ, perineural invasion, and progesterone receptor status. Altho ugh income, medical insurance coverage, and method of tumor detection expla ined some pathology differences, black patients still were more likely to h ave necrosis and a larger tumor size, even after adjustment. CONCLUSIONS, Black patients with breast carcinoma tend to be diagnosed at a younger age and in a few important respects have different tumor character istics compared with white patients, even after controlling for income, med ical insurance coverage, and method of tumor detection after screening mamm ography. These differences may have etiologic and clinical implications. Ca ncer 1998;83: 2509-15, (C) 1998 American Cancer Society.