Breast cancer survival has significantly improved over the past two decades. However, the diagnosis of breast cancer is lower and the mortality rate remains higher, in African American women (AA) compared to Caucasian-American women. The purpose of this investigation is to analyze postoperative events that may affect breast cancer survival. This is a retrospective analysis of prospectively collected data from The Brooklyn Hospital Center cancer registry from 1997 to 2010. Of the 1538 patients in the registry, 1226 are AA and 269 are Caucasian. The study was divided into two time periods, 1997–2004 (period A) and 2005–2010 (period B), in order to assess the effect of treatment outcomes on survival. During period A, 5-year survival probabilities of 75.37%, 74.53%, and 78.70% were seen among all patients, AA women and Caucasian women, respectively. These probabilities increased to 87.62%, 87.15% and 89.99% in period B. Improved survival in AA women may be attributed to the use of adjuvant chemotherapy, radiation, and hormonal therapy. Improved survival in Caucasian patients was attributed to the use of radiation therapy, as well as earlier detection resulting in more favorable tumor grades and pathological stages. 1. Introduction In the USA, breast cancer is the most commonly diagnosed malignancy in women. In 2010, it is estimated that approximately 200,000 women were newly diagnosed with breast cancer and, currently, 1 in 8 women will be diagnosed within their lifetimes [1]. The mortality picture and survival rate associated with breast cancer have been improving over the past two decades. These improvements have been reported to be related to early detection, adjuvant therapy, and radiation therapy [2–4]. However, despite overall improvement in survival, several reports indicate that African American (AA) females have poorer outcomes compared to Caucasian females [5]. Data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program indicate that age-adjusted breast cancer incidence rates in African Americans are substantially lower than those from Caucasian women with 141 cases per 100？000 in Caucasian women and 122 in African Americans [6, 7]. Although the incidence may be lower in AAs, the mortality rate appears to be higher compared to Caucasian women [8–10]. Numerous studies have proposed several theories to account for the racial differences in survival. Epidemiologically, AA women are diagnosed at a more advanced stage [11], have tumor-related characteristics that are more commonly estrogen receptor negative, and
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