• Christopher M Masi and Sarah Gehlert.
• Section of General Internal Medicine, University of Chicago, 5841 S. Maryland Avenue, M/C 2007, Chicago, IL 60637, USA. cmasi@medicine.bsd.uchicago.edu
• J Gen Intern Med. 2009 Mar 1; 24 (3): 408414408-14.

BackgroundWhile breast cancer mortality has declined in recent years, the mortality gap between African-American and white women continues to grow. Current strategies to reduce this disparity focus on logistical and information needs, but contextual factors, such as concerns about racism and treatment side effects, may also represent significant barriers to improved outcomes.ObjectiveTo characterize perceptions of breast cancer treatment among African-American women and men.DesignA qualitative study of African-American adults using focus group interviews.ParticipantsTwo hundred eighty women and 165 men who live in one of 15 contiguous neighborhoods on Chicago's South Side.ApproachTranscripts were systematically analyzed using qualitative techniques to identify emergent themes related to breast cancer treatment.ResultsThe concerns expressed most frequently were mistrust of the medical establishment and federal government, the effect of racism and lack of health insurance on quality of care, the impact of treatment on intimate relationships, and the negative effects of surgery, radiation therapy, and chemotherapy.ConclusionsIn addition to providing logistical and information support, strategies to reduce the breast cancer mortality gap should also address contextual factors important to quality of care. Specific interventions are discussed, including strategies to enhance trust, reduce race-related treatment differences, minimize the impact of treatment on intimate relationships, and reduce negative perceptions of breast cancer surgery, radiation therapy, and chemotherapy.

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