Black women wait longer for breast surgery than white women, study finds

New research involving breast cancer patients in the U.S. Military Health System found that black women wait longer to undergo breast cancer surgery after being diagnosed with the disease than white women, according to a study published Jan. 23 in JAMA Surgery.  

Researchers led by Kangmin Zhu, MD, PhD, of the John P. Murtha Cancer Center at the Uniformed Services University of the Health Sciences in Rockville, Maryland, noted that the longer time to surgery, however, did not account for the observed racial disparity in overall survival.  

The team analyzed records from U.S. Department of Defense Central Cancer Registry and Military Health System Data Repository-linked databases of 998 black women and 3,899 women (average age 50 years) between January 1998 through December 2008. All women were diagnosed with stages I to III breast cancer and underwent breast MRI or mammogram, breast-conserving surgery or mastectomy in the U.S. Military Health System.

The women were then compared at the 25th, 50th (median), 75th and 90th percentiles of time to surgery using multivariable quantile regression, the researchers noted.  

Study results included the following:  

• The average time to surgery was 21 days among white women and 22 days among black women.  
• Black women had a significantly greater estimated time to surgery at the 75th (average 3.6 days) and 90th (average 8.9 days) percentiles than white women.
• Black women had a higher adjusted risk for death compared with white women among patients receiving breast-conserving surgery.
• The risks were similar between races among those receiving mastectomy.  

The researchers noted that the longer wait times for black women suggests that factors other than access to care and insurance status may play a role in the longer time to surgery.

“In the universal access Military Health System, black women had longer time to surgery than white women. However, surgical delays did not appear to ex- plain observed racial disparities in survival,” Zhu et al. wrote. “Future research on factors that influence surgical decisions, treatment delays, and short-term and long-term clinical outcomes is warranted to better understand racial disparities in breast cancer treatment and overall survival.”