Nonclinical factors associated with women receiving partial mastectomies with radiation (P+R) compared with modified radical mastectomies without radiation (MOR) were examined in 2,238 black and white women diagnosed with early-stage breast cancer in the metropolitan Detroit area from 1985 through 1987.

“Black women did not differ from White women in treatment received. Stratifying on race, age at diagnosis remained the strongest predictor for White women, followed by hospital size. Among Black women, hospital size was more strongly associated with surgery received than age.”

“White women receiving treatment at smaller institutions are more likely to be seen
in suburban hospitals, while Black women are more often seen in urban hospitals. Thus, the treatment differences in the small hospitals are urban-suburban variations. Further studies should investigate whether Black women seen in small hospitals do not receive P+R as often because their physicians are concerned about treatment compliance for the radiation component, because radiation therapy is not available for at those hospitals, or because these women are not provided with adequate information about alternative treatments.”