Age and racial/ethnic disparities in the diagnosis of breast cancer in an urban population

Background: Breast cancer is a major cause of morbidity/mortality among New Jersey women; however its burden is not equally distributed. African American and Hispanic women develop breast cancer at an earlier age and are diagnosed at an advanced stage. African American and Hispanic women also have poorer breast cancer survival rates than non-Hispanic white women.

Objective/Methods: To characterize our population of breast cancer patients and explore these relationships we examined the clinical registry data of all women diagnosed with breast cancer from 1999-2004 at our urban university hospital.

Results: Of 394 cases reviewed, 56.1% were Black, 20.1% Hispanic and 5.3% non-Hispanic White. Mean age was 55 and 25.6% were diagnosed with advanced stage disease. Findings indicated significant differences in the proportion of breast cancer patients with advanced stage disease by age and race. The proportion of African American, Hispanic and non-Hispanic white women diagnosed with advanced stage disease varied (29%, 18% and 26% respectively). However, younger (<40 years) African American and Hispanic women (p=0.02) were more likely to be diagnosed with advanced stage breast cancer than non-Hispanic white women (29%, 42% and 14% respectively).

Conclusions: These findings highlighting age and race disparities in diagnosis have ramifications in regards to screening. Since mammography is not recommended, not cost effective as a screening tool and less sensitive in dense fibroglandular breasts, widespread screening is unlikely to be implemented in younger women. Effort needs to be placed on both increasing education on breast self examination in this population and investigating alternative imaging studies.