title: Racial disparities in physical and functional domains in women with breast cancer.
abstract: BACKGROUND
  African-American women are more likely than white women to have functional impairments after breast cancer (BC) surgery; however, no differences were found in self-reported health status surveys at 12+ months postsurgery.
  
  
  OBJECTIVE
  This analysis compared white and African-American BC survivors' (BCS) health status, health-related quality of life, and the occurrence of physical impairments after BC treatment.
  
  
  METHODS
  One hundred sixty-six women (130 white, 28 African-American, 8 other) were assessed for impairments preoperatively and at 1, 3, 6, 9, and 12+ months postsurgery. Health status was assessed at 12+ months using the Short Form Health Survey (SF36v2™). Analysis of variance estimated differences between groups for health status and impairment occurrence.
  
  
  RESULTS
  No differences were found between groups for BC type, stage, grade, or tumor size; surgery type; or number of lymph nodes sampled. African-American BCS had more estrogen/progesterone receptor-negative tumors (p < 0.001; p = 0.036) and received radiation more frequently (p = 0.03). More African-American BCS were employed (p = 0.022) and reported higher rates of social activities (p = 0.011) but less recreational activities (p = 0.020) than white BCS. African-American BCS had higher rates of cording (p = 0.013) and lymphedema (p = 0.011) postoperatively. No differences were found in self-reported health status.
  
  
  CONCLUSIONS
  In a military healthcare system, where access to care is ubiquitous, there were no significant differences in many BC characteristics commonly attributed to race. African-American women had more ER/PR-negative tumors; however, no other BC characteristics differed between racial groups. African-American women exhibited more physical impairments, although their BC treatment only differed regarding radiation therapy. This suggests that African-American BCS may be at higher risk for physical impairments and should be monitored prospectively for early identification and treatment.
authors: Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA.
authors: Alicia J
authors: AJ
authors: Morehead-Gee
authors: Lucinda
authors: L
authors: Pfalzer
authors: Ellen
authors: E
authors: Levy
authors: Charles
authors: C
authors: McGarvey
authors: Barbara
authors: B
authors: Springer
authors: Peter
authors: P
authors: Soballe
authors: Lynn
authors: L
authors: Gerber
authors: Nicole L
authors: NL
authors: Stout
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001943:Breast Neoplasms / Q000208:ethnology* / Q000503:physiopathology* / Q000628:therapy; D016009:Chi-Square Distribution; D015897:Comorbidity; D004185:Disability Evaluation; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D044465:White People / Q000706:statistics & numerical data*