Breast cancer patients at our institution frequently present with large tumors, thereby decreasing chances for cure or prolonged survival. Patients diagnosed with breast cancer in 1999 through 2004 were identified through the Tumor Registry of Pitt County Memorial Hospital; a regional hospital in Greenville, N.C.; 1,341 of the 1,565 patients identified had the tumor size recorded. Tumors of >or=5 cm. were found in 12.0% of all patients. Among African American women, 19.1% had tumors of >or=5 cm. (including 5.8% with tumors of >or=10 cm) whereas 14.5% of African American women nationally (1.9% >or=10 cm) had. For White women, 8.7% (1.3% >or=10 cm) had large tumors compared with 7.4% (1.19% >or=10 cm) nationally. Patients with Medicaid and without insurance at diagnosis were especially likely to have large tumors. In the United States, approximately 20,000 women yearly present with tumors of >or=5 cm. Large breast-cancers are a significant public health problem.