The authors carried out a retrospective analysis of 708 patients (94% blacks) with breast cancer who were diagnosed, treated and/or followed at Harlem Hospital Center (New York) between 1964 and 1986: nearly all patients were of low economic status with almost 50% having no medical coverage. Surgical treatment was implemented in 512 patients (72%). Radiotherapy and/or chemotherapy alone were used in 94 patients (13%); 102 patients (14%) refused treatment or died before its initiation. The 5-year and 10-year survival rates for those treated surgically were 39% and 27%, respectively. For those patients undergoing surgery (47% of whom were in Stages III and IV), 5-year and 10-year survival rates were analyzed according to stage of the disease. They were 54% and 54%, respectively, for Stage I; 56% and 35%, respectively, for Stage II; 41% and 18%, respectively, for Stage III; and 11% and 0%, respectively, for Stage IV. There was significant difference in the 5-year survival rates between patients with pathologically negative lymph nodes (64%) and a single positive lymph node (71%), compared to those with multiple positive lymph nodes (33%; P = 0.001). The 10-year survival rates were 39%, 34%, and 15% (P = 0.001), respectively. The authors conclude that breast cancer survival in this population of poor black women is low compared to the survival rate of black women nationally and very low compared to white women.