The incidence of @entity0 in the US is known to be higher among white than black @entity1 and among @entity1 of higher @entity159 ( @entity159 ), but once a @entity1 , either black or white, has the disease, she is more likely to have a recurrence and to die of @entity0 if she is of lower @entity159 . Explanations for these observed differences are varied and inconsistent making it clear that these reported differentials are not sufficiently understood. In understanding @entity0 in a multicultural setting, delay in diagnosis, follow-up, and treatment are frequently the focus of attention. However these factors do not sufficiently explain the observed differences between blacks and whites. A review of recent literature reveals an increasing focus on the role of @entity159 in @entity0 etiology, and progression; however, the confounding of @entity159 with race/ethnicity (black vs. white) contributes to the insufficient understanding of the effect of these two factors. This report will focus on the interplay between race/ethnicity and @entity159 and their relative effects upon analyses of survival from @entity0 . Findings are based on prospective clinical trial data. @entity159 factors have been associated with most of the known or suspected risk factors for @entity0 incidence and progression. In addition to race/ethnicity, @entity159 is also associated with diet, lifestyle factors, physical characteristics, and @entity5 characteristics. Without controlling for other risk factors, the ratios of risk for blacks with respect to whites for disease-free survival and overall survival were 1.30 (95% CI: 1.04-1.61) and 1.42 (95% CI: 1.15-1.76), respectively. However, after controlling for @entity1 risk factors, such as the number of positive lymph nodes, @entity5 diameter, @entity172 receptor status and socioeconomic factors, these differences decrease and are not statistically significant. Socioeconomic status is associated both with race/ethnicity and @entity172 receptor status. A loglinear analysis demonstrates that the apparent association of race/ethnicity with @entity172 receptor status is mediated by @entity159 . An implication of this finding is that environmental and lifestyle components rather than genetic factors associated with race may explain the observed differentials between black and white @entity0 @entity1 . Knowledge of environmental factors associated with @entity159 have the potential for providing important clues about the prevention and control of @entity0 .

Socioeconomic factors and XXXX in black and white Americans.

@entity1 :: ('9606', 'Species') :: ['women', 'woman', 'patients', 'patient'] @entity172 :: ('MESH:D004967', 'Chemical') :: ['estrogen'] @entity0 :: ('MESH:D001943', 'Disease') :: ['breast cancer'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor'] @entity159 :: ('MESH:D013226', 'Disease') :: ['SES', 'socioeconomic status']
@entity0 :: (MESH:D001943,Disease) :: ['breast cancer']
