Race is a Fundamental Prognostic Indicator for 2325 Northeastern Ohio Women with Infiltrating Breast Cancer


Address correspondence and reprint requests to: Joseph P. Crowe, Jr., MD, The Cleveland Clinic Foundation, Cleveland Clinic Breast Center, 9500 Euclid Ave., A80, Cleveland, OH 44195, USA, or e-mail: crowej@ccf.,org.


Abstract:  The goal of this research was to determine if race, independent of socioeconomic status, is a prognostic indicator for women diagnosed with infiltrating breast cancer. We hypothesized that black patients would present with breast cancers having less favorable prognostic indicators relative to white patients, regardless of socioeconomic status. Using data collected prospectively in our institutional review board approved breast center patient registry and 2000 Census Tract data for northeastern Ohio, we compared tumor size, node status, hormone receptor status, clinical outcomes, and socioeconomic status for patients who were self-described as either black or white and who had been diagnosed with infiltrating breast cancer. The chi-square test, t-test, log-rank test, and Cox proportional hazards analysis were used to analyze the data. Kaplan-Meier outcome curves were generated. Data were available for 2325 women, including 313 who were black and 2012 who were white. Compared to white patients, black patients were more likely to have positive axillary nodes and to have hormone receptor-negative tumors. Black patients were also more likely to have positive axillary nodes associated with smaller tumors. Independent of socioeconomic status, black patients were more likely to have poorer overall survival and disease-free survival rates for breast cancer relative to white patients. The prognostic significance of race was not dependent on a concomitant relationship with socioeconomic status.