Differences in Breast Cancer Stage, Treatment, and Survival by Race and Ethnicity

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Abstract
BLACK,1-7 HISPANIC white,1,2,7-10 and American Indian8,11 women seem more likely to be diagnosed as having advanced stages of breast cancer and to have poorer survival rates after diagnosis compared with non-Hispanic whites. Alternatively, Asian and Pacific Islander women, in the aggregate, have been observed not to differ from non-Hispanic whites with respect to breast cancer stage and survival rate.1,2 However, several studies suggest that there may be variations in these factors across different ethnicities included in the category of Asians and Pacific Islanders. One study1 of women living in the San Francisco Bay Area of California and 2 studies12,13 of women living in Hawaii reported that Hawaiian and Filipino women are more likely to be diagnosed as having advanced stages of breast cancer and to have poorer survival rates after diagnosis compared with non-Hispanic whites. Two of these studies12,13 also found that Japanese and Chinese women present with less advanced stages of breast cancer and have better survival rates than non-Hispanic whites. However, previous studies1,2,7-10,12 evaluating the relationship between race and ethnicity and breast cancer stage and survival rates have been limited in their sample sizes, in their ability to evaluate subgroups of Asians and Pacific Islanders and Hispanic whites, or in their generalizability, as most studied women from limited geographic regions.