What black women need to know about breast cancer
CANCER CARE AND RESEARCH • COURTNEY ALLISON’S STORY
For black women, breast cancer is the most commonly diagnosed cancer and the second leading cause of cancer death after lung cancer, according to the American Cancer Society. While black women and white women have breast cancer at roughly the same rate, black women are 40% more likely to die from the disease, according to a study by the Centers for Disease Control and Prevention.
“This is a telling fact that shows that there are disparities in breast health,” says Dr. Vivian Bea, chief of the surgical breast oncology section at NewYork-Presbyterian Brooklyn Methodist Hospital and assistant professor of surgery at Weill Cornell Medicine. “But we can’t attribute it to exactly one thing.”
Dr. Bea, who is committed to closing disparities through research and health initiatives, says many factors contribute to breast cancer disparities, from social determinants to genetics and tumor biology. She spoke to Health Matters about what black women should know about breast cancer risk and breast health, and dispels myths about breast cancer diagnosis.
1. Know the facts.
Researchers are working to better understand why there is such a huge disparity in breast cancer outcomes between black and white women. Access to care is an issue, but other factors include genetics and tumor biology, says Dr. bea. “We used to believe that breast disparities were mainly due to lack of access to health care, and then policies were put in place that actually improved mammography screening and the availability of insurance, but the disparity still exists,” she says.
Research indicates that genetics may play a role in this higher risk disparity, and risk may vary depending on a black woman’s ancestry, specifically in cases of triple negative breast cancer. Black women are more likely to have triple negative breast cancer, a rarer but more aggressive form that does not respond to hormone treatment. According to the American Cancer Society, triple negative breast cancer is about twice as common in black women as in white women in the US, and contributes to the lowest breast cancer survival rate among black patients. “It is important for black women to know their risk of breast cancer so they can educate themselves and be proactive about their health,” says Dr. bea.
Dr. Vivian Bea
2. Triage — and bring a friend.
Early detection is the best protection. “Even though black women are more likely to have triple negative breast cancer, if we catch these women at an early stage of this breast cancer, there is a better chance of survival,” says Dr. bea.
The American Cancer Society says women should have the option to start screening with annual mammograms at age 40 if they want to, and recommends that women start having annual mammograms at age 45, which may change every two years thereafter. of 55 years. If you have a family history, you should start testing earlier. “Black women are more likely to be diagnosed at a younger age with the more aggressive tumor subtype, so I recommend going annually starting at age 40,” says Dr. bea.
If you’re nervous about getting a mammogram, Dr. Bea recommends going with a friend so you can take responsibility and have moral support. “I understand that it’s not easy for everyone and it can be stressful,” she says. “Maybe do a spa day or a girls’ day afterwards to relieve the stress and anxiety around the appointment. Take the focus off the mammogram and turn it into a complete ritual.”
Through a multi-institutional grant from the American Cancer Society and Pfizer, Dr. Bea is focusing on improving access to screening mammography for black women in the Brooklyn community, extending hours at the NewYork-Presbyterian Brooklyn Methodist Hospital a few times a month and providing access to breast imaging at the NewYork-Presbyterian Lower Manhattan Hospital.
“We are also working with navigators within faith organizations to help spread the word and encourage women in their church to receive their annual mammogram, even in the era of COVID-19,” she says.
3. Don’t believe myths.
Understandably, there is a lot of fear surrounding a breast cancer diagnosis, but it is important to be aware of the many advances made in care. For example, Dr. Bea says some patients have expressed concern that if they are given a cancer diagnosis and have surgery, the surgery could cause the cancer to spread. “This is fake,” she says.
Women may believe that surgeons will have to remove their breasts, which is also not true. “We can offer modern approaches to breast surgery, such as mastectomy or breast-conserving surgery, which removes only part of the breast,” says Dr. bea. “These myths, along with a valid fear of COVID, may be widening the gap of women not getting mammograms now. But it is important to remember that early detection saves lives.”
She emphasizes that women should not let fear of COVID stop them from having their mammograms. “COVID is real, but women should know that it’s safe to go into the hospital for a mammogram,” she says. “It’s a risk-benefit situation. Wear a mask, practice social distancing and use hand sanitizer to balance that risk and get your mammogram done.”
4. Know your breasts.
Dr. Bea encourages women to have a breast self-exam every month. “If there is an abnormality, you will be the first to detect it,” she says. Signs to look out for include nipple discharge, a palpable mass (a lump), or any changes in the skin. “If you’ve never had eczema, a condition that makes your skin red and itchy, in your life, and you see changes in the skin on your breast, don’t assume it’s eczema. Go and see your provider,” she advises.
Clinical breast exams are important at least annually by a licensed professional.
Dr. Bea hopes that by building trust with her patients and prioritizing education, outreach and early diagnosis, she can address disparities in the community and save lives. “I have a voice and it is my duty to use it and be at the forefront of this conversation.” She says she is active on social media to try to reach even more patients.
Equally important is a diverse care team. “NewYork-Presbyterian Brooklyn Methodist Hospital has a multidisciplinary team of black women who treat breast cancer, which is rare,” says Dr. bea. “If you are diagnosed with breast cancer, it is important to receive high-quality care, which we offer here with a diverse, multidisciplinary department.”
“I love my position because I know I’m making a difference every day, even if it’s just in one lifetime,” says Dr. bea. “When someone who looks like me listens to me explain the risks of breast cancer and relate to them, understanding from a cultural perspective where they come from, we are able to connect and they are more likely to listen to me and trust me. . And that trust can make a difference in a life-or-death situation.”