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Insurance, Income Don't Explain 'Race Gap' in Breast Cancer Care
Date:10/12/2010

By Kathleen Doheny
HealthDay Reporter

TUESDAY, Oct. 12 (HealthDay News) -- The so-called racial gap in breast cancer care has long been known by researchers, with black and Hispanic women less likely to get recommended breast cancer treatments than white patients.

"Less well known is what the issue is -- is it race itself or something else contributing?" said Dr. Rachel Freedman, a medical oncologist at Dana Farber Cancer Institute in Boston, and an instructor in medicine at Harvard Medical School.

Her team's new study suggests that financial factors such as economic and social class or access to insurance alone can't explain the "gap": Even after accounting for those differences, racial disparities in breast cancer care still showed up.

The study, published online Oct. 11 in the journal Cancer, "was unique because it included adult women of all ages, and included [those with] insurance," Freedman said.

Freedman evaluated information on more than 662,000 white, black and Hispanic women diagnosed with invasive breast cancer from 1998 to 2005. She used data from the U.S. National Cancer Data Base, a registry that collects information on patients' treatments, outcomes, insurance and socioeconomic status.

In the database, 86 percent of the women were white, 10 percent black, and 4 percent Hispanic.

When they evaluated whether women got the correct treatments and testing, the team found no differences by race/ethnicity for hormone receptor testing (evaluating whether a cancer is estrogen-receptor positive or negative, which could help guide treatment).

But they did find differences in other interventions. For example, black women had lower odds of getting recommended treatments -- interventions such as mastectomy or breast-conserving therapy, chemotherapy and hormone therapy (such as aromatase inhibitor drugs to reduce recurrence risk), Freedman said. And Hispanic women were less lik
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