This study assessed the relationship of race and patterns of care, defined by an expert NCI-appointed committee, for 7,781 patients with breast cancer treated in 107 hospitals in 45 communities between 1982 and 1985.

“After control for age and stage of disease, black patients had significantly different care from white patients for four of the ten patterns examined. They were less likely to have a progesterone receptor assay or to be referred for postmastectomy rehabilitation, two patterns deemed desirable for all patients. Black patients were also more likely to receive liver scans and radiation in situations in which these procedures were labeled ‘less appropriate (as defined in the text).’ …The patterns that showed racial differences were not the most clinically significant of the ten studied. Different treatment differences for black and white patients may help to explain differences in survival rates of black and white women with breast cancer.”

The authors note, “a few studies of racial differences in the quality of in-hospital services also suggest consistent differences, with minority patients generally receiving care regarded as lower in quality…Race-related differences in treatment of cancer have been reported in three studies. Chu, et al. found that fewer black patients had optimal care for stage I cervical cancer, although the differences were only marginally significant. Axtell and Myers reported that twice as many blacks as whites had no treatment of their breast cancer between 1960 and 1966 (6% vs. 3%). McWhorter and Mayer found that blacks were more likely than whites to have their breast cancer go untreated, as well as less likely to be treated surgically.

This study found that “black and white breast cancer patients received similar care on six clinically important measures. Black patients received significantly different care from white patients for four of the ten patterns examined, with black patients receiving less appropriate care in each case.

“These findings differ somewhat from those in the literature in that the previous studies found black patients receiving fewer of the more expensive services while we find that they received more of some services, but “less appropriate” services.

“Despite these limitations, the data suggest less appropriate work-up and care for black patients with a malignant, but treatable, chronic disease.”