Is Breast Cancer Different for Black American Women?
Many people are aware of the disparities in breast cancer diagnosis and survival between white women and non-white women. In Black American women less than 50 years old, the incidence (the number of these women who get breast cancer) is less than that for white American women. The shocking part of this data is that for Black American women, the death rate is 40 percent higher than white women. Let me put this in plain terms to summarize: Black American women have less breast cancer but die at higher rates than our white counterparts.
Why Is There a Disparity in Black Women With Breast Cancer?
Why is there such a disparity? Thanks to many researchers around the country; we are starting to get the answers to this puzzling question. It is well-known that Black American women below age 50 tend to have a more aggressive tumor that spreads very quickly. Once a cancer spreads throughout the body, it is more difficult for us to control (although not impossible). In my personal experience with this particular group of women, small tumors (less than 2 cm) are found to have spread to other parts of the body when diagnosed compared to other subtypes.
Research has found that these women have a special subtype of breast cancer, called triple-negative. One of the biggest differences is that they lack estrogen, progesterone, and HER-2 receptors. We have developed drugs to block these receptors, thus controlling the growth and spread of breast cancer cells. The triple-negative status limits the number of medications available to this group of women for treatment.
There are also many practical issues that contribute to these horrible statistics. We, as Black American women are not doing our self-breast exams, we are not getting our mammograms as recommended by the American Cancer Society, and we are not paying attention to our family history. In my practice, I have found that these are due to fear and misinformation. Fear of losing a breast is a valid concern. However, with early detection, lumpectomy (removal of breast mass only, leaving the rest of the breast intact) is an option. Many of my physician colleagues have not grasped the concept that a breast mass in women younger than age 50 could be breast cancer. We as physicians have to do a better job at recommending mammograms in women younger than 50 with a breast mass (the youngest breast cancer patient I have seen is age 21).
It is great news that we are starting to answer this difficult question, and this research will lead to more research and answers. As an Black American woman and physician, I am concerned about my own health as well as the health of the many young women that I see in my office. We have much to learn about how breast cancer affects women of all races and ethnicities. We must get involved in the research process. We must be part of the research process that will help save our daughters, granddaughters, and future generations.
Author: Regina Hampton, MD, FACS
Dr. Regina Hampton is medical director and co-founder of Breast Care for Washington. Dr. Hampton is a featured expert in our health equity-focused Pro Hub that lists inclusive global healthcare professionals committed to advancing inclusive research and providing the highest quality care to all patients.
We thank Dr. Hampton for her continued dedication to patients and families.
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