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Black Women and Breast Cancer: Why the Disease Affects Us More Severely

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According to medical research, no matter the stage of type of breast cancer, women of color are more likely to be diagnosed later in the disease than their white counterparts. Minority women are also less likely to get the recommended treatments for breast cancer.

Previous studies have found these disparities, but new research reveals that this is true “across all breast cancer subtypes,” according to Lu Chen, study lead author. Chen is also a researcher in the public health sciences division at Fred Hutchinson Cancer Research Center in Seattle. This information was printed in a news release from the American Association for Cancer Research (AACR). The study was funded by the U.S. National Cancer Institute, and was published on October 13 in the Cancer Epidemiology, Biomarkers & Prevention journal.

Chen’s research team looked at data from 18 cancer registries based in the United States. The researchers analyzed the stage of cancer, tumor size and grade, demographics, and health insurance status for more than 100,000 living in the U.S. the research team also recorded the subtypes of the tumors, which pertain to care and prognosis.

These investigators looked at the hormone receptor (HR) of the tumor, which indicates how sensitive the tumor is to hormonal therapies. The team also looked at whether or not the tumor tested positive for HER2, or human epidermal growth factor 2-neu, which can indicate that the tumor(s) are particularly aggressive.

The researchers found that when compared to Black women, white women were more likely to have smaller tumors, and were also more likely to suffer from less aggressive variations of breast cancer. Women of other ethnic or racial groups were also more likely than their white peers to be diagnosed while in the advanced stages of breast cancer.

Black women in particular were more likely to have aggressive breast cancer, also known as “triple-negative” cancer, and to have large tumors. They were 40 to 70 percent more likely to be diagnosed during the later stages of the disease, regardless of the breast cancer subtype. The study also found that across all breast cancer types, Hispanic women were also 30 to 40 percent ore likely to be diagnosed during stage 2 or 3 of breast cancer.

Women also experienced treatment disparities based on race and ethnicity. For nearly all breast cancer types, Black women were 30 to 60 percent more likely to get “inappropriate” treatment, according to the study. Hispanic women were 20 to 40 percent more likely to receive “substandard care” for breast cancer. According to the study, White women and Asian-American women received no difference in treatment.

Even after Chen’s research team took the health insurance status of the women into account, these health disparities were still present. Two breast cancer experts shared that they, unfortunately, were not shocked by these findings.

“It is well known that disparities in breast cancer affect women from minority groups, and in particular African Americans,” said Dr. Paolo Boffetta, a professor of medical oncology at the Icahn School of Medicine at NYC’s Mount Sinai.

However, the study led by Chen’s research team delves into this issue deeper, confirming that “the disparities at each stage of the natural and clinical history of the disease,” according to Dr. Boffetta.

Boffetta also states that addressing these health disparities, which is resulting in a higher death rate from breast cancer in minority women, should be “given the highest priority in the global effort to combat breast cancer.”

Dr. Stephanie Bernik, who is chief of surgical oncology at Lenox Hill Hospital in New York City, stated that the reasons for substandard care in minority racial and ethnic groups when it comes to breast cancer diagnosis is not clear. She does, however, point out that socioeconomic status plays a significant role, since women with less financial resources are less likely to seek the care they need and follow through with treatments.

“There needs to be more study as to how to optimize treatment for these women, as current strategies are not effective enough,” Dr. Bernik said.

More information on health care disparities in terms of cancer treatment can be found at the U.S. National Cancer Institute.

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