594 CANCER February 1, 1996 / Volume 77 / Number 3

REFERENCES 1. Weiss SE, Tarrier PI, Ahmed S. Brower ST, Brusco C, Bossolt

K. et al. Ethnic differences in risk and prognosis factors for breast cancer. Cnncer 1995; 76264-74. Sanchez MA. Arch Pntlzol Lab Med 115:425. 1991. 2.

Miguel A. Sanchez, M.D. Engleiuood Hospital and Medical Center

Englewood, New Jersey; Mount Sinai School of iMedicine

New York, New York

Author Reply

e appreciate the comments of Dr. Sanchez concern- W ing the heterogeneity of the population that we re- ferred to as Hispanic. However, we will continue to use this distinction for two reasons: the patients refer to themselves as Hispanics and one of our major interests is explaining why African-Americans have a much higher mortality rate from breast cancer than white’s and yet have a lower risk for the disease.

As Dr. Sanchez is aware, many previous studies have tried to attribute this difference to differences in prognos- tic factors. However, our study found no differences in prognostic factors between African-Americans and whites

with the exception of body weight and tumor size. The study of Hispanics in New York is valuable because His- panics have a socioeconomic status and lack of access to health care comparable to that of African-Americans with the addition of a language barrier. However, Hispanics have a breast cancer mortality rate that is comparable to the white population and lower than that of the African- American population. By comparing breast cancer among African-Americans with breast cancer among Hispanics, one is controlling for socioeconomic status and access to health care to some degree.

We strongly feel that the distinction of Hispanics in our breast cancer population is useful because it aids us in identifying prognostic factors that are independent of socioeconomic status and health care access.

We thank Dr. Sanchez for his comments. Although in principle we agree, in our population the distinction is useful.

Stephanie Weiss, B.A. Paul I. Tartter, M.D.

Sharmilla Ahmed, B.A. Steven T. Brower, M.D.

Cristina Brusco, M.D. Kathy Bossolt, B.A. Joan Bratton, B.A.

James B. Amberson, M.D. The Department of Surgery

The Mount Sinai Medical Center New York, NY

Dianon Systems Stratford, CT