Breast cancer is the second leading cause of cancer death in the US, with American Cancer Society (ACS) estimating that 55,720 new cases of ductal carcinoma in situ/stage 0 breast cancer and over 300,590 new cases of invasive breast cancer were diagnosed in women in the US
The good news is that earlier diagnoses, wider awareness, and improved treatment technology have resulted in a 43% reduction in breast cancer deaths over the last thirty yearsa mortality gap remains between black and white women.
This gap is extremely stark because although white women have higher rates of breast cancer diagnosis, black women are 40% more likely to pass from the disease.
The difference is even more devastating between women under 50 years of age; although younger women in general have a higher chance of developing aggressive cancers, the the death rate is twice as high among young black women than young white women.
This disparity has not abated for over a decade, and while there are factors such as socioeconomic disparities and screening practices that we can analyze, research is still ongoing and there is no specific cause that doctors can pinpoint.
Understanding the facts and figures behind this disparity and the possible reasons why this disparity exists can help people make informed decisions about their personal health.
Black women are more likely to be diagnosed with triple-negative breast cancer
One of the driving forces behind the higher death rate for black women with breast cancer is that Black women are twice as likely as white women to be diagnosed with triple-negative breast cancer.
Triple negative breast cancer is unfortunately much less treatable than other types of breast cancer because it is progesterone receptor negative, HER2 receptor negative and estrogen receptor negative, meaning that targeted drugs such as hormone therapy cannot be used to the treatment of the disease. More invasive, physically tougher types of treatments are usually requiredsuch as chemotherapy, surgery or radiation.
Moreover, Triple negative breast cancer is much more aggressive from other types of breast cancer, so she has a more likely to spread through the body in other organs and areas before it is diagnosed. It is also more likely to come back after remission, creating more deadly outcomes for many patients.
Black women have higher rates of early breast cancer
Another possible factor that increases the risk of black women developing breast cancer is that breast cancer in young black women is higher than in young white women andrequires earlier screening practices – which is exacerbated by access to screening and treatment.
23% of all breast cancers in black women were diagnosed before age 50, while only 16% of breast cancers in white women were diagnosed before age 50. Many national agencies do not estimate the prevalence of breast cancer in younger black women who are under 50 years of age.
Organizations such as the US Preventive Services Task Force, the American College of Physicians, and the American Academy of Family Practice recommend that women start taking regular mammograms at age 50, which may not be the best practice for black women, given the higher rate of diagnoses at younger ages.
This is the reason Breast cancer screening and screening are essential for black women at a younger ageand access to care and education about this issue can save many lives.
Guidelines for care are based on studies of white women
As we discussed above, many breast cancer prevention guidelines issued by national health organizations do not necessarily include all racial demographics.
Health care providers and public health professionals are working hard to reduce the death rate among black breast cancer patients by focusing on the key initiatives of increasing screening, promoting community education, and emphasizing early diagnosis.
RResearch targeting the ways in which factors such as socioeconomic status, race, and access to care at different stages affect outcomes for breast cancer patients can help structure future intervention strategies that are more inclusive of everyone’s experience of patients, helping to reduce the disadvantage of some when it comes to early detection.
The Harvard Journal announced some interesting findings supporting the above statements published in the prestigious medical journal JAMA Surgery. According to the report, current guidelines from major health organizations, which are based on data from predominantly white populations, may lead to delayed diagnosis in non-white women.
A team of Massachusetts General Hospital researchers analyzed the racial disparity in clinical guidelines and found that racial differences in the stage of tumors at the time of diagnosis and the ages of patients indicate a need to change the guidelines to require early screening of some non- white women.
Some facts and figures they found that could be applied to create new guidelines include:
- The median age at diagnosis for white women was 59
- The average age at diagnosis was 56 for black women
- The median age at diagnosis for Asian women was 46
- The median age at diagnosis for Hispanic women was 55
- Nonwhite women were diagnosed at higher rates before age 50
Fortunately, if the information from these studies is properly applied, the risks of overtreatment and overdiagnosis could be reduced through continued advances in clinical practice and screening technologies.
Nonwhite women in particular could be screened earlier, and early detection in minority patients could reduce the cost of additional testing, making it a win-win situation for health care providers.
