Growing Gap Seen in Advanced Breast Cancer Survival Between Black and White Women

June 3, 2007

An analysis of women with advanced breast cancer over the past two decades has found that disparities in breast cancer survival between black and white women have increased. Although breast cancer-specific survival rates continuously increased for white women, they did not change for black women.

"We've made huge strides in the treatment of advanced breast cancer, but, as a group, black women are not benefiting from these improvements," said Sharon Giordano, MD, MPH, Assistant Professor, Department of Breast Medical Oncology at The University of Texas M. D. Anderson Cancer Center in Houston and the study's senior author.

The researchers identified 15,438 women who were newly diagnosed with stage IV breast cancer between 1988 and 2003 in the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program. The women were grouped according to the year of diagnosis: from 1988 to 1993, 1994 to 1998, and 1999 to 2003. Both survival and breast cancer-specific survival (meaning that death was from breast cancer) rates were measured.

Researchers found that women diagnosed between 1988 and 1993 lived for 16 months, with a breast cancer-specific survival of 20 months. Women diagnosed between 1994 and 1998 lived 18 months, with a breast cancer-specific survival of 21 months. Women diagnosed between 1999 and 2003 lived 20 months, with a breast cancer-specific survival of 25 months.

When the white women were compared with the black women, the difference in breast cancer survival increased over time. From 1988 to 1993, white women lived an average of 20 months, compared with 17 months for black women. From 1994 to 1998, white women lived an average of 22 months, compared with 16 months for black women, and from 1999 to 2003, white women lived an average of 27 months, compared with 17 months for black women.

After considering other factors that affect survival, such as age, tumor grade, number of lymph nodes with cancer cells, and estrogen receptor status, the researchers found that race remained a significant factor in survival over time. "It is likely that a variety of factors are responsible for this, including access to health care and screening programs and differences in treatment," said Dr. Giordano.

What This Means for Patients

This analysis shows that women are living longer with stage IV breast cancer, but these improvements are seen primarily in white women, and these differences are increasing over time. It is important for all women to know that advanced breast cancer is treatable.

Because the information available in the SEER database is limited, the researchers were not able to compare differences in treatment that the patients received. Future research will focus on examining the factors causing racial disparities and ways to eliminate them.