Figure 1

A model for the initiation and development of breast cancer disparities in African American versus Caucasian women. The model depicts the relationship of biological abnormalities that occur to a greater extent in the tumors of African American women, and nonbiological factors that are more frequent in African Americans, in the initiation and development of breast cancer disparities. The biological activities are considered to be the main contributing factors to the type and outcome of the disparities. The nonbiological activities are considered to influence primarily the biological activities, and are organized according to what is considered to be the main manner of influence on the biological activities - to promote or inhibit, to facilitate, or to act as confounding factors. It is through this influence on biological activities that the nonbiological factors influence disparity outcome. The nonbiological factors may also influence the disparity directly, although this is considered to be less common. The nonbiological factors are depicted in overlapping circles to indicate that they may interact with each other, and the nonbiological factors may act alone or in combination to influence these outcomes. ER, estrogen receptor.