Breast cancer in Native American women treated at an urban-based indian health referral center 1982-2003

Background: Breast cancer incidence and survival varies by race and ethnicity. There are limited data regarding breast cancer in Native American women. Methods: A retrospective chart review was performed of 139 women diagnosed with breast cancer and treated at Phoenix Indian Medical Center in Phoenix, AZ between January 1, 1982 and December 31, 2003. Data points included tribal affiliation, and quantum (percentage American Indian Heritage) along with patient, tumor, and treatment characteristics. Results: Most patients (79%) presented initially with physical symptoms. There were no significant differences based on tribal affiliation; however, higher quantum predicted both larger tumor size and more advanced stage at diagnosis. Obesity also significantly correlated with larger tumor size and more advanced stage. Treatment was inadequate in 21%; this was attributed to traditional beliefs, patient refusal, or financial issues. Conclusions: When compared to national averages, Native American women presented at a later stage, underutilized screening, and had greater delays to treatment.