Reasons for disparity in breast cancer treatments not all black and white

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The medical community has gradually become aware of a difference between the care that black and white women with invasive breast cancer receive. It had been typically assumed that the discrepancy was due largely to reduced access to care. Now, however, a new study shows that, even when both groups have equal access to health care, the disparity remains.

In a new study published in the journal Cancer, researchers based at Walter Reed Army Medical Center and the National Cancer Institute compared the breast cancer treatments of 2,700 white and black women, all of whom had the same access to care through military health insurance. They found that, while the two groups of women were equally likely to have a mastectomy or lumpectomy, black women whose tumors had spread beyond the breast were 60 percent less likely than their white peers to receive chemotherapy, and 50 percent less likely to receive hormonal therapy.

For now, researchers remain uncertain why this disparity exists. Earlier studies had speculated that higher rates of poverty and lower rates of health insurance coverage were responsible. This new study, however, eliminated those factors. And while researchers now wonder whether cultural differences offer an explanation, what the study demonstrates most clearly is the reality of the disparity. Now that this is a recognized phenomenon, says ACSH s Dr. Gilbert Ross, it s very important that it be further investigated. Both he and ACSH s Dr. Elizabeth Whelan believe a follow-up study that would interview the women who declined treatment, as well as their physicians, is a necessary step. A new, prospective study might also offer some answers.