Stephanie B. Wheeler|Katherine E. Reeder?Hayes|Lisa A. Carey
Disparities in Breast Cancer Treatment and Outcomes: Biological, Social, and Health System Determinants and Opportunities for Research
University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill
abstract racial disparities breast cancer mortality widely documented several decades persist despite advances receipt mammography across racial groups persistence leads questions roles biological social health system determinants poor outcomes cancer outcomes function innate biological factors also modifiable characteristics individual behavior decision making well characteristics patienthealth system interaction health system attempts explain persistent racial disparities mostly limited discussion differences insurance coverage socioeconomic status tumor stage diagnosis comorbidity molecular subtype tumor article summarizes existing literature exploring reasons racial disparities breast cancer mortality emphasis treatment disparities opportunities future research breast cancer care requires high degree multidisciplinary team collaboration ensuring guideline recommended treatment endocrine therapy hormone receptor positive patients received racialethnic groups critical requires coordination across multiple providers health care settings recognition variation cancer care quality may correlated race socioeconomic health system factors may assist policy makers identifying strategies equally distribute clinical expertise health infrastructure across multiple user populations