In our study, the 5-year risk of death, from any cause, was 1.37 for African American women with breast carcinoma; in other words, the mortality rate for African AmeriThe authors are grateful to Ruth Byers, Staff can women was 24.77% compared with 18.08% for white women. In the latest Officer, U.S. Army Medical Command, for providing many reports and substantial guidance SEER data, the 5-year relative risk of death for African American women compared in the use and management of the Department with white women is 1.86. The mortality rate in SEER is 34.2% for African American of Defense (DoD) Central Tumor Registry women and 18.4% for white women. The survival rate for white DoD beneficiaries (ACTUR).is comparable to that for white women in SEER.CONCLUSIONS. These observations suggest that ready access to medical facilities

This study reviewed mammographic screening related to breast carcinoma diagnosis and treatment between 1987 and 1997 at Brooke Army Medical Center, San Antonio, TX. Epidemiologic data from the Department of Defense Automated Central Tumor Registry were merged with data from patients' medical records and responses of the patients or their families to a mailed survey. The cases of 907 women grouped by race-white, African American, and Hispanic-were analyzed. Breast carcinoma diagnosed by mammographic screening showed a reversed ratio of early to late stage of cancer occurring for all three groups. That ratio was 1.45 for African Americans, 2.67 for Hispanics, and 3.08 for whites. For those women diagnosed with screening mammography, no statistically significant difference in 5-year survival was found between the races: 86% for whites, 83% for Hispanics, and 80% for African Americans. Mammographic screening as a diagnostic tool appears to equalize survival among whites, Hispanics, and African Americans, in spite of differences in age, stage of diagnosis, and military rank used as a proxy for socioeconomic status. When not controlling for mammographic diagnosis, Kaplan-Meier analysis revealed significant differences in survival patterns between whites, Hispanics, and African Americans. Five-year survival rates were 71% for whites, 74% for Hispanics, and 53% for African Americans. Screening mammography reduced 5-year mortality by almost 59% in African Americans, 52% in whites, and 36% in Hispanics. Whites were diagnosed with breast carcinoma, on average, at 57 years of age-11 years later than African Americans (average age 46 years) and 7 years later than Hispanic women (average age 50 years). As a diagnostic tool, screening mammography was used to discover breast cancer in 36% of white women, 33% of Hispanics, and 22% of African Americans. Further research is recommended to examine the use of mammography among various racial/ethnic groups.