Abstract Introduction Breast cancer is the most common malignancy among women (accounting for approximately 27% of all new noncutaneous cancers in women) and the second most common cause of cancer- related death among women in the United States. The lifetime occurrence of breast cancer was recently reported as approximately 1 in 8 women. 1 Annual mammographic screening has improved the detection of breast cancer at earlier stages with a concurrent decrease in mortality. 2 Several studies have looked at various factors that might play a potential prognostic role in this disease, includ- ing age at diagnosis, histology, and race. All of these factors have been correlated with differences in mortality rates among various population groups. Previous research has shown that black women have higher mortality rates from breast cancer than other major racial groups, although the specific causes of racial disparity in breast cancer survival remain unclear. 3 These higher mortality rates are thought to be at least partially explained by the more advanced stage at time of diagnosis, which is observed in black patients with breast cancer. 4 Furthermore, breast cancer in black women is more likely to be higher grade, and these patients are more likely to present with a larger tumor size at diagnosis. Although most breast cancers express sensitivity to antiestrogen therapy, black patients appear to be more likely to have estrogen receptor–negative (ER – ) disease compared with white women, which excludes potentially effective Race as an Independent Risk Factor for Breast Cancer Survival: Breast Cancer Outcomes From the Medical College of Georgia Tumor Registry Carlos H. Barcenas, 1 Jeremy Wells, 1 Daniel Chong, 1 John French, 1 Stephen W. Looney, 2 Thomas A. Samuel 1 Background: Causes of racial disparities in breast cancer survival remain unclear. This study assesses overall sur- vival (OS) after diagnosis between black and white women and examines factors that might correlate with this dis- parity. Patients and Methods: Data were obtained from the Medical College of Georgia Tumor Registry. Cases in- cluded those diagnosed between 1990 and 2005. We analyzed race, stage, age of diagnosis, and treatment received: chemotherapy, radiation, surgery, and hormonal therapy. A Cox proportional hazards model was used to determine differences in OS. Results: Compared with 670 white women, 489 black women were more likely to be younger, have later-stage disease at diagnosis, and were less likely to have received hormonal therapy. Both groups received similar rates of radiation, surgery, and chemotherapy. Black women had significantly poorer OS (adjusted hazard ratio, 1.35; 95% CI, 1.12-1.63). White women had a 5-year OS of 54% compared with 45% in black women (P = .0031). Having received radiation, surgery, or chemotherapy was not associated with OS. White women were more likely to have re- ceived hormonal therapy, which had a significant protective effect. However, a stratified analysis (between those who received hormonal therapy and those who did not) showed similar results, whereas black women experienced poorer OS in both strata. Conclusion: Black women with breast cancer had a significantly poorer OS compared with white women. White women received more hormonal therapy, which had a protective effect. There were no differences in treatment received regarding radiation, surgery, or chemotherapy, and these treatments were not associated with OS. The reasons for racial disparities in breast cancer OS remain complex. Clinical Breast Cancer, Vol. 10, No. 1, 59-63, 2010; DOI: 10.3816/CBC.2010.n.008 Keywords: Hormone receptor status, Hormone therapy, Prognostic factors Original Study This summary may include the discussion of investigational and/or unlabeled uses of drugs and/or devices that may not be approved by the FDA. Electronic forwarding or copying is a violation of US and International Copyright Laws. Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by CIG Media Group, LP, ISSN #1526-8209, provided the appropriate fee is paid directly to Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923 USA. www.copyright.com 978-750-8400. 1 Deparment of Medicine, Section of Hematology/Oncology 2 Department of Biostatistics Medical College of Georgia, Augusta Submitted: Mar 12, 2009; Revised: Jul 22, 2009; Accepted: Aug 25, 2009 Address for correspondence: Thomas A. Samuel, MD, Department of Medicine, Section of Hematology/Oncology, Medical College of Georgia 1120 15th St BAA- 5407, Augusta, GA 30912 Fax: 706-721-5566; e-mail: tsamuel@mcg.edu Clinical Breast Cancer February 2010 | 59