Racial differences in the early detection of breast cancer in metropolitan Detroit, 1978 to 1987

Article Abstract:

An increase in the incidence of early breast cancer, or an increase in the diagnosis of breast cancers less than 2 centimeters (cm) without invasion of local lymph nodes, has been observed in recent years. This increase is presumed to be the result of more widespread availability of mammography and increasing awareness of the importance of screening for breast cancer. A similar increase in the diagnosis of early breast cancer was observed in the Detroit area. However, an analysis of 17,216 breast cancer cases between 1978 and 1987 reveals that black women are not sharing proportionately in the improvements in breast cancer diagnosis. Between 1985 and 1987, 18.7 percent of the cases of newly diagnosed breast cancer among black women were early, in contrast with a rate of 29.2 percent among white women. Breast cancers less than 1.0 cm constitute only 3.5 percent of newly diagnosed breast cancer among black women, while 7.9 percent of the new cases among white women are of that size. These observations are particularly important when considering the disparity in breast cancer mortality between white and black women. While some of the increased mortality of black women is due to the lower rate of early diagnosis, some is also due to the generally lower socioeconomic status of blacks in the United States. According to one study, the observed 30 percent difference between the breast cancer mortality rates of blacks and whites is reduced to 10 percent if the contribution of socioeconomic status is adjusted. Since demonstration projects of the National Cancer Institute and the American Cancer Society were able to achieve early diagnosis rates of 30 percent of breast cancers smaller than 1.0 cm, and Detroit has not hit 10 percent, it is clear that Detroit has a long way to go. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Mortality, Detroit, Michigan, Michigan, Blacks, Mortality and race, Black race

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Breast cancer screening behaviors and attitudes in three racial/ethnic groups

Article Abstract:

In the United States, breast cancer is the most common cancer among women, whether black, white, or Hispanic. The incidence of breast cancer among white women actually tends to be higher than for black or Hispanic women. However, the rate of mortality from breast cancer is roughly the same for blacks and whites, indicating that although black women are less likely to get breast cancer, they are more likely to die if they do. This is borne out by the survival statistics, which indicate that the five-year survival for white women with breast cancer is 75 percent, while the five-year survival for black women is 63 percent. All of the factors which contribute to this racial difference in survival are not yet certain. However, some of the difference may result from a greater likelihood of early diagnosis, and hence more successful treatment, among white women. To explore further racial and ethnic factors which influence breast cancer mortality, a major study has been conducted to compare the attitudes towards breast cancer screening among white, black, and Hispanic woman, and to evaluate their behavior in availing themselves of screening services. Among women over 40, 39 percent of white women reported having had a mammogram, in contrast with 30 percent of black women and 26 percent of Hispanic women. When asked whether they had a mammogram in the last year, 17, 14, and 13 percent of whites, blacks, and Hispanics, respectively, responded affirmatively. The reasons given for not having had a mammogram differed in quantity among the three groups, but were similar in pattern. The two most common reasons given for not having had a mammogram was no referral by a physician and the cost. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health, Medical screening, Health screening, Mammography, Health and race

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The process of recovery from breast cancer for younger and older patients: changes during the first year

Article Abstract:

While breast cancer is a serious, life-threatening disease, the psychological aspects of the illness may be equally important to the patient's quality of life. A recent study of 274 breast cancer patients showed that the physical impairment in the first few months after treatment was the greatest predictor of mental health and well-being later on. While comparisons between 4 and 10 months after treatment showed a marked improvement in physical functioning, the same cannot be said for mental health. In fact, the greater the physical impairment at the time of the first interview, the greater the deterioration in mental health that was likely to be observed in the second. Younger patients fared significantly worse in this regard than did older patients. While increasing age tends to worsen the debilitating effects of surgery, older patients were also less likely to perceive this impairment as a significant reduction in the quality of life. It is interesting to note that the stage of the breast cancer at the time of diagnosis was less important to the patients than the debilitation. The stage of the disease at diagnosis is an objective indicator of prognosis and threat to life; the debilitation after surgery is a greater perceived threat, however, and this is what has the greatest impact on the patient's well-being. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Surgery

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