The goal of this paper is to review the existing literature assessing the relationship of patient sociodemographic characteristics, geographic region, and hospital/physician characteristics with treatment for breast cancer.

The published literature indicates that women who are older, black, without medical insurance, or treated in non-teaching or small hospitals are less likely to receive treatment as recommended by national guidelines. Variation in radical versus breast-saving surgery for local-stage breast cancer seems to vary by these characteristics, but less is known about variation in the use of systemic treatments.

While many studies have described these patterns over time, researchers tend to inadequately control for potential clinical and sociodemographic characteristics, leaving a full understanding of this problem and the most efficient solutions incomplete. For example, it will be important to not only consider patient and provider characteristics in describing treatment differences, but also the influence of cost and outcomes. Additionally, the quality of communication between patients and physicians is a potentially important area for future research.