title: Breast cancer in Native American women treated at an urban-based Indian health referral center 1982-2003.
abstract: BACKGROUND
  Breast cancer incidence and survival varies by race and ethnicity. There are limited data regarding breast cancer in Native American women.
  
  
  METHODS
  A retrospective chart review was performed of 139 women diagnosed with breast cancer and treated at Phoenix Indian Medical Center in Phoenix, AZ between January 1, 1982 and December 31, 2003. Data points included tribal affiliation, and quantum (percentage American Indian Heritage) along with patient, tumor, and treatment characteristics.
  
  
  RESULTS
  Most patients (79%) presented initially with physical symptoms. There were no significant differences based on tribal affiliation; however, higher quantum predicted both larger tumor size and more advanced stage at diagnosis. Obesity also significantly correlated with larger tumor size and more advanced stage. Treatment was inadequate in 21%; this was attributed to traditional beliefs, patient refusal, or financial issues.
  
  
  CONCLUSIONS
  When compared to national averages, Native American women presented at a later stage, underutilized screening, and had greater delays to treatment.
authors.affiliation: Department of Surgery at Phoenix Indian Medical Center, 4212 N. 16th St., Phoenix, AZ 85016, USA. Laura.Tillman@pimc.ihs.gov
authors.forename: Laura
authors.initials: L
authors.lastname: Tillman
authors.forename: Shannon
authors.initials: S
authors.lastname: Myers
authors.forename: Barbara
authors.initials: B
authors.lastname: Pockaj
authors.forename: Charles
authors.initials: C
authors.lastname: Perry
authors.forename: R Curtis
authors.initials: RC
authors.lastname: Bay
authors.forename: Mazin
authors.initials: M
authors.lastname: Al-kasspooles
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000628:therapy*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007198:Indians, North American; D008327:Mammography; D008875:Middle Aged; D009367:Neoplasm Staging; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D016549:United States Indian Health Service / Q000706:statistics & numerical data*; D014505:Urban Population