Quality of Breast Cancer Care: Perception Versus Practice Results Of the 374 new patients with early-stage breast cancer enrolled onto the RCT, only a slight majority of women (55%) perceived their quality of care as excellent; 88% actually received good-quality, guideline-concordant care. Excellent perceived quality (P < .001) was significantly associated with patients' perception of the quality of the process of getting care (adjusted relative risk [RR], 1.78; 95% CI, 1.65 to 1.87). Also associated with perceived quality-and mediated by race-were trust in one's physician (adjusted RR, 1.43; 95% CI, 1.16 to 1.64) and perceived racism, which affected black women more than women of other races/ethnicities (black race–adjusted RR for perceived racism, 0.33 [95% CI, 0.10 to 0.87]; black race–adjusted RR for trust, 1.61 [95% CI, 0.97 to 1.90]; c = 0.82 for the model; P < .001). Actual quality of care provided did not affect perceived quality of care received. Conclusion Patients’ perceived quality of care differs from their receipt of high-quality care. Mutable targets to improve perceived quality of care include the processes of getting care and trusting their physician.   Nina A. Bickell,   Jennifer Neuman,   Kezhen Fei,   Rebeca Franco and   Kathie-Ann Joseph ### Corresponding author: Nina A. Bickell, MD, MPH, Mount Sinai School of Medicine, 1 Gustave L. Levy Place, Box 1077, New York, NY 10029; e-mail: .(JavaScript must be enabled to view this email address).