A recent article in the New York Times highlighted something we’ve spoken of before: the unfair distribution of deadly breast cancers between races.
Differences in breast cancer between different races exist - for complex, often daunting, and in many cases not fully understood reasons. Some racial differences can be explained by genetics - this is the reason for the higher numbers of breast cancer found in women of Ashkenazi jewish descent who have a higher likelihood of genetic mutations that affect breast cancer risk. More complex is the differences in breast cancer between African-American women and white Americans. African-American women are less likely to get breast cancer than Caucasian women, yet are more likely to die from it.
And the differences are not small. On average, a black woman with breast cancer has a lower chance of surviving for 5 years after diagnosis than a white woman. Nobody claims to know the entirety of the problem or solution. One reason for the differences in survival are that African-American women are more likely to be diagnosed with advanced stage disease. Second, their cancers are more likely to have negative hormone receptors, removing the option of certain treatments. More black women will have triple negative breast cancer - a cancer with more limited options for treatment - but note this only applies to around 10% of breast cancer cases.
Why the late diagnosis? We can only speculate about the reasons for the differences. Advanced stage breast cancers are more likely to be found in women who have not undergone routine breast cancer screening - so we’re back to our old chorus - early detection saves lives.
How do we achieve early detection?
By going for annual screening mammograms.
By monthly self-exams.
By annual clinical breast exams (CBEs).
By visiting the doctor early when there are symptoms and going for diagnostic mammograms.
By living a healthy lifestyle, getting enough exercise and maintaining a health BMI.
What are some of the barriers to undergoing screening that uniquely affect our African-American women, and more importantly what can we do about it? Access to screening is key. Access and removal of barriers that keep women from going must be a priority for communities across the United States. Having health insurance and having health insurance that covers routine mammography is a great start.
Knowledge is key: information, cultural changes and dispelling myths and fighting fiction (there are many) with facts related to breast cancer are all important facets of the solution to this situation.
Hopefully, someday soon, we will see this painful gap in the war on breast cancer come to a close - leaving no one at greater risk of dying than others. And even better yet, our New Year’s wish remains simple - end breast cancer.
Originally published 1/7/14 on mammographykc.com.