HEALTHY REASONING: Black Women Have A Higher Breast Cancer Death Rate Than White Women

By Allan Bucka Jones
Pride Health Columnist

In May 2013, actress Angelina Jolie revealed that she had double mastectomy surgery (removing both breasts) to prevent breast cancer, a disease she had an 87 percent chance of contracting because of her genetic history, and more recently she went under the knife again to remove her ovaries, to eliminate her 50 percent risk of developing ovarian cancer.

While most women may not be as drastic as Ms. Jolie, to have surgery to reduce their risk for breast cancer, her action has brought increased attention to breast cancer, and to the greater susceptibility of certain individuals and ethnic groups to develop breast cancer.

Nothing speaks more clearly to the shocking breast cancer health disparities, than the fact that Black women are less likely than White women to get breast cancer, yet have a higher breast cancer death rate.  Breast cancer is the most commonly diagnosed cancer among Black women. In 2010, the United States Centers for Disease Control and Prevention (CDC) reported that breast cancer was the leading cause of cancer death for Black women aged 45-64 years. What was most alarming in this CDC report was that the breast cancer death rate for women aged 45-64 years was 60% higher for Black women than White women.

The growing breast cancer disparities that exist between Black women and White women are alarming. Although the overall lifetime risk of breast cancer is lower for Black women compared with White women, the death rates are higher. It is important to note that Black women also have a lower 5 year survival rate at 77% compared to that of 90% for White women.

Black women up to age 44, have a higher incidence of breast cancer than White women. Breast cancer tends to appear in Black women at a younger age and in more advanced forms. In fact, Black women are two times more likely to develop triple negative breast cancer, an aggressive form of the disease which has fewer effective treatment options. Triple-negative breast cancers tend to grow and spread more quickly than most other types of breast cancer. Black women are also known to have denser breast, one of the strongest predictors of risk for breast cancer and also is a known factor limiting the sensitivity of a screening mammogram.  Mammograms of breasts with higher density have been described as harder to read and interpret than those of less dense breasts.  A small cancer can be concealed by dense breast tissue or by the overlap of normal breast structures.

Despite these differences in the way breast cancer shows up earlier in Black women, many in the early 30s, the Canadian Cancer Society recommends that you start a dialogue regarding mammography with your doctor at age 40. I suggest that age 40 is much too late for many Black women who develop the aggressive triple negative breast cancer, because they could be dead by the time they reach age 35. It is critical that Black women demand earlier screening. This again points to the fact that a “one size fits all” approach to health care in Canada should be changed to a diversity based approach, where your treatment is based on your many risk factors, a key one being your ethnicity.

Many women with early breast cancer have no symptoms.  That is why it is so crucial to get screened before symptoms have a chance to appear.   However, the most common sign of breast cancer is a new lump or mass. A painless, hard mass that has irregular edges is more likely to be cancerous, but breast cancers can be tender, soft, or rounded. For this reason, it is important that you have any new breast mass or lump checked by a health care professional experienced in diagnosing breast diseases.

Other signs may include swelling of all or part of the breast, skin irritation or dimpling, pain in the breast or nipple, thickening of the nipple or breast, discharge other than breast milk.

The unfortunate reality is that Black women have not benefited from the advances in breast cancer research and new technologies. Early detection is critically important, especially for women at higher risk. For Black women who have been diagnosed at the earliest stage of breast cancer, when the tumour is small and localized, early diagnosis can make a difference.

The onus is on the woman to help herself in the early detection of anything unusual with her breasts. The following approach is useful: Have your family doctor show you how to perform a monthly breast self-examination (BSE), and perform it faithfully at the same time each month. There is some ongoing debate in Canada as to the usefulness of BSE; See your family doctor provider for a clinical breast examination (CBE) at least once a year;  Based on your age, let your doctor recommend the timings of  mammograms;  Since breast density is one of the strongest risk factors for Black women developing breast cancer, insist on digital mammography or some of the newer more advanced technologies that help detect tumours.

Women, pay attention to your breasts…it may save your life.

Allan Bucka Jones is a Health Promoter and Broadcaster. He can be heard on “Allan Bucka Jones LIVE”, Sundays from 3 to 5pm on CHRY 105.5 FM, CHRY RADIO App, www.chry.fm option RDO.to, Rogers Digital Cable 945, Bell Fibe 973 or mobile app TuneIn Radio. You can contact Allan Bucka Jones at allan@jonesandjones.ca.