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The report, in the American Cancer Society's peer-reviewed journal Cancer, found black women have a lower rate of breast-cancer survival, attributed to a number of factors. Findings show the disparity could be blamed on aspects such as healthcare access, socioeconomic status, physician and/or patient bias or body mass index. Additionally, evidence suggests the race is associated with tumor biology that is more difficult to treat.

"'African-American' is an incredibly broad label -- it's a very diverse group of women", said Dr. Wendy Woodward, a radiation oncology physician at M.D. Anderson and the lead author of the study.

"We're hoping these studies will generate enough interest to look into this more and explore other options for women who aren't responding to current treatments", Woodward said.

In researching the issue, factors such as a disparity in access were controlled for, according to Woodward. Even so, African-American ethnicity appears to be an increased risk for overall mortality.

"Cultural bias, education, income, no health insurance, fear of the medical establishment -- many of these socioeconomic factors were similar between African-American and Hispanic women. It's an interesting control to show", Woodward said.

Beyond such attributes, the diseases in black women appeared to be of a more aggressive type: higher in grade and more difficult to treat. Specifically, data suggests that some were estrogen-receptor negative, meaning that in multidisciplinary treatment, some patients failed to respond to hormone therapy.

"When the disease isn't responsive to hormone treatments, we have to take a valuable tool off of the table", Woodward said.

Evidence points to the tumor and breast biology in African-American patients as possible elements in the disparity, but it remains unclear what the true cause of the worse prognosis may be.

"It could be an environmental or ancestral commonality in the biology, but we need additional research and attention", Woodward said. She hopes to raise awareness in order to learn more about the gap in breast-cancer survival.

"How big of a component does tumor biology play? How do we take the next step and ask scientific questions? I think there's enough data out there to strongly believe biology is a big part of it, but it's hard to measure the magnitude without more information", Woodward said.

In a retrospective analysis, where race questions were not asked at the beginning of the study but rather looked back upon, "you notice things you couldn't foresee", such as a possible selection bias, Woodward said. "Is it a larger tumor because it's more aggressive, or because it was presented later, after a delay in the referral? It's better to ask these questions before in order to balance the limitations."

Woodward and other researchers hope increased awareness of the issue will yield further research into the biology of cancer in African-American women, and in turn help determine more effective treatments to eradicate the disparity.