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

ely than white women to get hormonal therapy.

Freedman found black women 9 percent less likely than white women to get mastectomy, breast-conserving surgery or other treatments, 10 percent less likely to get hormonal therapy and 13 percent less likely to get chemotherapy.

Importantly, these disparities persisted even after the researchers accounted for insurance coverage and socioeconomic status. "In this study, even with those with the same insurance, there were race gaps," Freedman said.

"Further investigation is needed," she said, "to figure out which [other] factors are meaningful."

Freedman said the study does have limitations, including her finding of relatively modest absolute differences in the care different types of patients received. Even so, because breast cancer is so often diagnosed, these small discrepancies would end up affecting large numbers of women, she said.

While the database was large, the information was not always complete. Information was missing on many women. For instance, more than 46,000 women were excluded from the chemotherapy analysis, because data was missing.

One expert agreed that a gap in care linked to race does seem to persist.

Despite the study's limitations, "it does look like there still are racial differences, but tempered somewhat by insurance and socioeconomic status," said Dr. Nina Bickell, associate professor of healthy policy and medicine, Mount Sinai School of Medicine in New York City.

But for women of any race diagnosed with breast cancer, the message is the same, said Bickell. "I would tell anybody they should be getting information, and there's lots of excellent information available to those with breast cancer."

"Get it from credible sources," she said, such as the American Cancer Society.

She also recommends that women diagnosed with breast cancer write a list of questions before they go in for a doctor visit, take a friend or family member with t
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