Boddie et al1 have reviewed a series of urban poor patients treated for locally advanced breast cancer. Most patients, 24 of 37, included in their study are African American, with small numbers of other groups including Hispanics and whites. The authors found that the response rate to adjuvant therapy in this group of patients is similar to that of large studies involving predominantly white patients and patients from more diverse socioeconomic groups. It is often difficult to separate the influences of poverty from those of race. Other studies have found that minority patients had a delayed presentation, poorer response rates, or both to standard treatment for breast cancer. Many of these studies however are incomplete in separating the specific influences of race from simply poorer health care or differential treatment by physicians.
In this study Boddie et al have attempted to separate delayed presentation from differences in response to