title: Racial disparity in survival from early breast cancer in the department of defense healthcare system.
abstract: BACKGROUND
  Racial disparity is often identified as a factor in survival from breast cancer in the United States. Current data regarding survival in patients treated in the Department of Defense Military Healthcare System is lacking.
  
  
  METHODS
  The Department of Defense Automated Central Tumor Registry (ACTUR) was queried for all women diagnosed with Stage I or II breast cancer from January 1, 1996 through December 31, 2008. Statistical analyses evaluated demographics, surgical treatment, tumor stage, and survival rates.
  
  
  RESULTS
  There were 8,890 patients meeting inclusion criteria. Patients who were younger, Asian American (versus white or black), lower T and/or N stage had significantly improved survival rates. Interestingly, white and black patients demonstrated similar survival in this study. Patients with a longer period of time between diagnosis and treatment had no decrement in survival. As would be expected, patients with a longer recurrence free period enjoyed longer survival.
  
  
  CONCLUSIONS
  Survival from early stage breast cancer is equivalent between white and black patients in the Department of Defense Healthcare System. This finding is contrary to reports from our civilian counterparts and may be indicative of improved access to care and overall improved cancer surveillance.
authors.affiliation: U.S. Institute of Surgical Research, Fort Sam Houston, Texas.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Rizzo
authors.forename: William E
authors.initials: WE
authors.lastname: Sherman
authors.forename: Cletus A
authors.initials: CA
authors.lastname: Arciero
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People / Q000706:statistics & numerical data*; D001943:Breast Neoplasms / Q000208:ethnology / Q000401:mortality* / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D009364:Neoplasm Recurrence, Local / Q000208:ethnology / Q000401:mortality* / Q000601:surgery; D009367:Neoplasm Staging; D011379:Prognosis; D012042:Registries / Q000706:statistics & numerical data; D015996:Survival Rate; D014481:United States; D044465:White People / Q000706:statistics & numerical data*; D001741:Black or African American
keywords: Department of Defense; breast cancer; survival