Background Compared to non-inflammatory breast cancer (non-IBC), inflammatory breast cancer (IBC) has less favorable survival and is more likely to be estrogen receptor (ER) and progesterone receptor (PR) negative. ER+/PR+ tumors, regardless of histology, have less favorable survival. While black women are more likely to have IBC and ER+/PR+ tumors than white women, it is unclear whether the racial disparity in survival is explained by these factors. The objective of this study was to assess racial/ethnic differences in breast cancer survival by inflammatory histology and hormone receptor status. Methods This study examined breast cancer mortality among non-Hispanic white (NHW), Hispanic white (HW), black, and Asian/Pacific Islander (API) women diagnosed between 1990 and 2004. Kaplan-Meier survival curves and Cox proportional hazard ratios (HRs) assessed the relationship between race/ethnicity and survival. Results Black women had significantly poorer survival than NHW women regardless of inflammatory histology and hormone receptor status. Compared to NHWs, the HRs for black women were 1.32 (95% CI 1.21–1.44), 1.43 (95% CI 1.20–1.69) and 1.30 (95% CI 1.16–1.47) for IBC, IBC with ER+/PR+, and with ER−/PR−, respectively. Similar HRs were found for non-IBC, non-IBC with ER+/PR=, and non-IBC with ER−/PR−. API women had significantly better survival than NHW women regardless of inflammatory histology and hormone receptor status. Conclusion Compared to NHW women, black women had poorer survival regardless of inflammatory status and hormone receptor status and API women had better survival. These results suggest that factors other than histology and hormone receptor status may play a role in racial/ethnic disparities in breast cancer survival.

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Background While the incidence of bladder cancer is twice as high among whites than among blacks, mortality is higher among blacks than whites. Unequal access to medical care may be an important factor. Insufficient access to care could delay cancer detection and treatment, which can result in worse survival. The purpose of this study was to evaluate whether survival differed between black and white bladder cancer patients in the Department of Defense (DoD), which provides universal healthcare to all beneficiaries regardless of racial background. Methods This study was based on data from the U.S. DoD Automated Central Tumor Registry (ACTUR). White and black patients histologically diagnosed with bladder cancer between 1990 and 2004 were included in the study and followed to the end of 2007. The outcomes were all-cause mortality and recurrence. We assessed the relationship between race and outcomes of interest using Cox proportional hazard ratios (HRs) for all, non-muscle invasive (NMIBC), and muscle invasive (MIBC) bladder cancers, separately. Results The survival of black and white individuals did not differ statistically. No significant racial differences in survival (HR: 0.96, 95% CI: 0.76–1.22) or recurrence-free survival (HR: 0.94, 95% CI: 0.69-1.30) were observed after adjustment for demographic variables, tumor characteristics, and treatment. Similar findings were observed for NMIBC and MIBC patients, respectively. Conclusion Black patients were more likely to present with MIBC than white patients. However, white and black patients with bladder cancer were not significantly different in overall and recurrence-free survival regardless of muscle invasion. Our study suggests the importance of equal access to healthcare in reducing racial disparities in bladder cancer survival.