income, metastatic breast cancer, race



  1. Rosenzweig, Margaret Quinn PhD, FNPBC, AOCNP
  2. Wiehagen, Theresa BA
  3. Brufsky, Adam MD, PhD
  4. Sillaman, Anne MSN
  5. Arnold, Robert MD


The purpose of this study was to better understand the perceived challenges, barriers and potential influences of race and income on management of symptoms that influence the metastatic breast cancer experience. The study was conducted using a 2x2 mixed methods prospective design. Women with metastatic breast cancer were categorized into four groups based on race and income, and black low income. Quantitative techniques were used to assess symptom distress, quality of life, and to classify women into groups according to race and income. Instruments were 1) Symptom Distress Scale, 2) Functional Assessment of Cancer Therapy, and 3) semi structured interview assessing the breast cancer experience. The preliminary results are for 86 women with full data. Mean age was 56.1 years. Qualitative data elucidated differences not found in quantitative data. Prevalent themes among all racial and economic groups were of the hope, faith, and progressive loss. Important distinctions were evident among low income women. Black low income women spoke to physical, social distress and uncertainty regarding treatment goals while white low income women verbalized an overall optimism and minimization of self and symptoms while describing themselves as "lucky". The finding support the universality of the MBC experience, yet there are unique emerging racial and economic influences, particularly among low income women that should be considered in better tailoring of care.