In a recent Community Conversations (CC) session, we discussed how breast cancer affects black women. As I learned about breast cancer, I was surprised that proper breast health and care is something I should be thinking about actively, especially as a young black woman. While the incidence of breast cancer in white women was previously higher than that of black women, recent reports revealed that the incidences between the groups are becoming more and more equivalent. It is important that we understand the facts and take necessary preventative measures against breast cancer.
As the Black Women’s Health Imperative describes, black women tend to have denser breast tissue making it more difficult to detect abnormalities and increasing the risk to develop breast cancers. The onset of breast cancer in black women also tends to occur at younger ages, often with more aggressive, later stage and more challenging to treat forms of breast cancer. Some women have a family history of breast cancer. For these women, there may be an identifiable genetic cause increasing their risk for developing breast cancer. Meeting with a genetic counselor, women can determine if genetic testing for a cancer pre-disposition gene is appropriate.
With this knowledge, we must be more vigilant about our breast health and engage in early screening measures. These include regular breast self-exams to find lumps, nipple discharge or changes, or skin changes. Breast lumps are firm masses found in the breast or under your arm and can change the size and shape of the breast. Although lumps near breast tissue are usually not cancerous, women should always have lumps and other abnormalities checked as soon as possible by a health care provider.
Surprisingly, experts in breast cancer don’t always agree on recommendations including whether breast self-exams can make a difference A quick survey of our CC program faculty who think actively about health risks faced by black women, suggests that regular breast self-exams may be important for black women. This stands in contrast to recently released ACS guidelines—though these guidelines are for women with ‘average’ breast cancer risk.
I was quite astonished to learn that there are conflicting recommendations among experts for yearly clinical breast exams (exams performed by a healthcare professional). While some groups no longer advocate for this, others like our CC faculty continue to believe in it. Early screening and timely follow-up of results are important for catching early stages of breast cancer, as early stage cancers are more manageable to treat.
Mammograms can reveal lumps and abnormal calcium deposits as well as breast cancers. African-American women should be especially cognizant of this since black women tend to be diagnosed at more advanced stages of breast cancer. Again, recommendations differ among experts but among those familiar with black women’s breast health risks, many still advocate for beginning yearly mammograms at age 40 (American College of Radiology, Society of Breast Imaging, Komen Foundation.) Women with a family history of early onset breast cancer should consult with their health providers to determine if they should begin imaging screening earlier. Since having a family history of breast cancer increases a woman’s risk for developing breast cancer, it is important to talk with family members (on both mother’s and father’s sides) about breast cancer in the family.
Additionally, I learned that black women tend to suffer from triple negative breast cancer, a form of breast cancer that is more aggressive and more difficult to treat. In triple negative breast cancer, breast cancer cells lack three common hormone receptors: the estrogen receptor, the progesterone receptor, and the hormone epidermal growth factor receptor 2 (HER-2). While chemotherapy is still effective in targeting triple negative breast cancer, hormone therapy—which targets these hormone receptors—cannot be used to treat this type of cancer. Although most women with breast cancer do not have a family history, women carrying mutations in two tumor suppressor genes, BRCA 1 and BRCA 2, have higher risks of developing triple negative breast cancer.
Since there are such large gaps between the survival rates between black and white breast cancer patients, let’s be inspired to be active in our healthcare and learn more about breast cancer to take preventative measures against it.
See more about the facts of breast cancer here[link in progress].