DETROIT--Socioeconomic status has been overemphasized in efforts to explain why African-American women have worse breast-cancer outcomes than Caucasian women.

So suggested a meta-analysis of 14 studies that factored in affluent African-American women. It came to the conclusion that ethnicity is an independent predictor of a worse breast-cancer outcome-even after adjusting for socioeconomic status.

"This meta-analysis finding does not necessarily indicate that African Americans have biologically different types of breast tumors," Dr. Lisa A. Newman of the Karmanos Cancer Institute here and colleagues reported in the June 1 Cancer.

"However, it does indicate that biologic and genetic predictors of breast-cancer outcome that are associated with different ethnic groups and with different socioeconomic backgrounds are measured poorly and are understood incompletely."

The meta-analysis included 10,001 African-American patients and 42,473 white American patients with breast cancer. "Both ethnicity and socioeconomic-related variations in breast cancer outcome may be affected by residual confounding from other factors," the investigators said. "The true determinants of outcome may be related to nutrition, genetics, environmental exposures, lifestyle, and/or variation in the delivery of treatment."

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