title: Are There Differences in Treatment and Survival Between Poor, Older Black and White Women with Breast Cancer?
abstract: OBJECTIVE
  To explore differences in treatment and survival outcome between poor, older black and white women with breast cancer.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Public safety net hospital.
  
  
  METHODS
  Women aged 65 and older diagnosed with breast cancer from 1999 to 2008 (n = 1,000).
  
  
  METHODS
  Breast cancer treatments that black and white women sought were compared using the Pearson chi-square test. All-cause mortality of black and white women was compared using hazard ratios derived from a multivariate Cox proportional hazards model.
  
  
  RESULTS
  There was no significant difference between older black and white women in surgical treatment, radiation therapy, chemotherapy, or hormone therapy over the study period. Race was not a significant predictor of survival in the Cox proportional hazards model that controlled for stage of cancer, age at diagnosis, dual-eligibility status, comorbid conditions, body mass index, smoking history, mammogram screening, and treatment for breast cancer.
  
  
  CONCLUSIONS
  Race did not appear to affect treatment or mortality in a cohort of older women with low socioeconomic status. This may be associated with similar healthcare delivery and equivalent access to health care for the older black and white women in this study.
authors.affiliation: Health Services Research, Indianapolis, Indiana.|Regenstrief Institute, Inc., Indianapolis, Indiana.
authors.forename: Himani
authors.initials: H
authors.lastname: Aggarwal
authors.affiliation: Regenstrief Institute, Inc., Indianapolis, Indiana.|Center for Aging Research, Indianapolis, Indiana.|Department of Medicine, Simon Cancer Center Indiana University, Indianapolis, Indiana.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Callahan
authors.affiliation: Regenstrief Institute, Inc., Indianapolis, Indiana.|Indiana University Melvin and Bren, Simon Cancer Center, Indianapolis, Indiana.
authors.forename: Kathy D
authors.initials: KD
authors.lastname: Miller
authors.affiliation: Department of Biostatistics, Indiana University, School of Medicine, Simon Cancer Center Indiana University, Indianapolis, Indiana.
authors.forename: Wanzhu
authors.initials: W
authors.lastname: Tu
authors.affiliation: Regenstrief Institute, Inc., Indianapolis, Indiana.|Indiana University Melvin and Bren, Simon Cancer Center, Indianapolis, Indiana.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Loehrer
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D044383:Black People / Q000706:statistics & numerical data*; D001943:Breast Neoplasms / Q000208:ethnology / Q000401:mortality* / Q000628:therapy*; D015331:Cohort Studies; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007196:Indiana / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008408:Mastectomy / Q000706:statistics & numerical data; D015412:Mastectomy, Segmental / Q000706:statistics & numerical data; D011203:Poverty; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant / Q000706:statistics & numerical data; D012189:Retrospective Studies; D044465:White People / Q000706:statistics & numerical data*; D001741:Black or African American
chemical_list: D000970:Antineoplastic Agents
keywords: black; breast cancer; elderly; survival; white