OBJECTIVES This study examined recent trends in age- and race-specific patterns of breast cancer mortality. METHODS We analyzed breast cancer mortality data for 1979 through 1996. RESULTS From 1993 to 1996, White women of all age groups experienced average annual decreases in breast cancer mortality. Throughout the study, young Black women had higher rates of breast cancer mortality than young White women. Older Black women had lower mortality rates than older White women in the earlier years of the study but experienced higher rates in the later years (1993-1996). CONCLUSIONS Trends in risk factors and early detection do not provide an adequate explanation for this recent substantial increase in breast cancer mortality among older Black women.