“Treatment of breast cancer in black women appears to be similar to that in white women, but little is known about systemic therapy choices and efficacy. The discrepancy in survival rate between black and white women exists because black women have tumors that are more advanced at the time of diagnosis, because tumor biology in black women is different from that in white women, and because of confounding comorbid conditions and socioeconomic factors.”

“In black women, the most commonly cited reasons for not having mammography are a belief that mammography is not needed if no clinical breast problems are present, the failure of a physician to recommend the procedure, the cost of the procedure, and a knowledge deficit about the increasing risk of breast cancer with age. These barriers are the same as those mentioned by white women, although black women more frequently cite lack of physician recommendation as an important reason for not obtaining yearly mammography.”

“Intervention by health care providers can significantly improve short-term compliance with breast cancer guidelines by black women.”

“Large population-based studies have repeatedly shown that black women have breast tumors at a more advanced stage at the time of diagnosis.”

“More advanced stage at diagnosis, differences in tumor biology, treatment differences, sociodemographic issues, and the presence of comorbid illnesses have all been suggested as factors contributing to the poorer survival of black women with breast cancer…Several groups have found that black and white women with disease in a very early stage (lymph nodes not involved with cancer) and women with metastatic disease have similar survival; those with intermediate prognosis disease (local or regional disease and lymph nodes not involved with cancer) continue to show a disparity in survival. This raises the possibility that treatment differences may also play a role in the outcome disparity, because adjuvant treatment has its greatest absolute effect on women with local or regional disease and lymph nodes involved with cancer.”

“To close the survival gap between black and white women… it is particularly important to develop a better understanding of the treatment options available to all black women, the choices these women make about therapy, and the efficacy of therapy in black women and white women.”