Although black women are less likely to develop breast cancer than whites, and other ethnic groups, those who do have the disease are almost twice as likely to die from it.

      Doctors traditionally have blamed socioeconomic factors for the difference, including less access to health care and less aggressive treatment after diagnosis. A new study--funded by the National Institutes of Health and the U.S. Department of Health and Human Services and conducted at (the) Ohio State (University) and 39 other locations--shows that biological factors also affect the prognosis for black women.

      The study, involving 156,000 patients, found several determining factors. Black women are more likely to have estrogen-negative and progesterone-negative cancer, that is, cancer not fed by hormones, which gives them fewer treatment options. And they are far more likely to have more aggressive tumors that are difficult to treat.

      "It's a triple negative," said Electra Paskett, associate director of Ohio State's Comprehensive Cancer Center. "Black women are less likely to get regular mammograms than whites, and those in the study were almost twice as likely to be obese. But even accounting for these factors, they were unexplained differences in the outcomes."

      Paskett says tumor characteristics alone may not explain all the ethnic differences. "Clearly we need more research to understand how the disease develops."

      Doctor Walker adds: The Breast Cancer Surgery Center has always welcomed women of color to our "practice family". This includes not only African-Americans, but also women from the Carribean (Antigua, Bahamas, and Jamaica) and women from middle Eastern countries such as India and Pakistan. We welcome cultural diversity and have been cited for our excellent awareness of cultural and ethnic differences.