Killelea BK, et al. - Given that black women are more likely to have aggressive tumors with less favorable histology, and to have a worse prognosis whereas white women have higher breast cancer incidence, researchers examined how modifiable risk factors including obesity and alcohol consumption associate with the race to impact the severity of breast cancer. They queried data collected as part of a large prospective study looking at insulin resistance and race among women with breast cancer for patient characteristics, lifestyle factors and tumor characteristics. The cohort comprised 746 women [82% (n=615) white and 18% (n=131) black; mean age: 58 years]. Black breast cancer patients more frequently had high BMI (31.0 vs 26.7), comorbidities (69% vs 55%), self-reported poor diet (70% vs 42%), be sedentary (56% vs 46%) and were less likely to consume alcohol (8% vs 32%) compared to white patients. Among modifiable risk factors, diet and exercise are noted to be associated with Nottingham Prognostic Index. The most important determinants of prognosis were unmodifiable factors including race and biologic subtype.