For African American women, breast cancer

treatment isn't a given

With a Stage 3 breast cancer diagnosis, chemotherapy and radiation are

often urgently needed. And many African American women refuse them.

In a study published in the July 1 issue of Cancer, researchers at Emory

University found that of 107 women diagnosed with Stage 3 breast cancer, of
whom almost 87% were African American, a fifth of patients decided against
chemotherapy. More than a fourth chose not to get radiation. (Here's more
information on chemotherapy and radiation from breastcancer.org.)

African American women may be more reluctant to pursue such treatment

because of the time involved (they're often caretakers of others) and, of
course, because of the cost.

With African American women being diagnosed with advanced breast cancer
at almost twice the rate of white women, we need to figure out how to
overcome such treatment resistance. Researchers in the study helped launch
a community outreach clinic. That's obviously just the beginning.

-- Tami Dennis

Breast cancer is the most common cancer diagnosis among African American
women, and among women nationwide.1 Studies have shown that when African
American women follow the same preventive measures as white women, their
death rates from breast cancer are very similar. However, African American
women are more likely than white women to be diagnosed at later stages of the
disease and are more likely to die from it.

The incidence of breast cancer among African American women is slightly lower
than it is for white women. In any given year, 95 out of 100,000 African
American women are diagnosed with breast cancer, compared to 112 out of
every 100,000 white women.2 However, African American women are slightly
more likely to develop breast cancer before age 50, and white women are more
likely to develop breast cancer after age 50.
SOURCE: Ries LAG, Eisner MP, Kosary CL, Hankey BF, Miller BA, Clegg L, Edwards BK (eds). SEER Cancer Statistics
Review, 1973-1998, National Cancer Institute. Bethesda, MD, 2001.
Reasons Behind Racial Differences

A number of studies have looked into the question of why the breast cancer
mortality rate is higher for African American women than white women. They
have looked at whether breast cancer affects African American women
differently than it does women of other races. The results are not conclusive.
Some studies show no basic differences across races.3 However, a recent study
found tumor cells in African American women growing more rapidly, and
concluded that this could lead to more aggressive cancers at an earlier age. This
study also found that African American women may be less responsive to
hormone treatment.5

Statistics show that overall, when African American women are diagnosed, they
have larger tumors and their breast cancer has spread further (i.e. to the lymph
nodes and to other parts of the body).6 This is unfortunate because when breast
cancer is discovered at more advanced stages, it is more difficult to treat, and
survival rates are lower.

Survival
The five-year breast cancer survival rate
for African American women is 69%,
whereas it is 84% for white women.7
Overall, the past 5 years have seen an
increase in the number of women who
undergo hand-examinations by their
doctors and mammograms to check for
lumps in their breasts. However, African
American women have fewer
mammograms than white women and are
likely to be diagnosed after the cancer has
spread.

Researchers have shown that African American women who have regular
mammograms have the same excellent chances of surviving breast cancer as all
other groups of women.6 Tumors found early can be more easily treated and
are more likely to be cured. Click here to learn about other methods of
detecting breast cancer and the symptoms to look for in a breast self-exam.

All states and territories of the United States have programs that cover the cost
of mammograms when insurance does not. Contact the American Cancer
Society at 1-800-ACS-2345 to find the locations of these services in your
community.
Treatment

African American women may be less likely to undergo appropriate treatment

because of a higher frequency of low income, single parent households.
Consider the following:

• Time - Breast cancer treatment is both time consuming and draining.

Women, who are often used to taking care of others, need to instead be
taken care of while they complete treatment.
• Cost - Breast cancer treatment can be expensive, even if insurance
covers the actual costs of treatment. There can also be additional travel
costs, childcare costs, or costs for general home upkeep. Women may
also lose wages when they miss work.
• Undertreatment - African American women are less likely to receive
appropriate treatment, according to a study published in the American
Journal of Public Health. Whether they were young or old, in early or late
stages of breast cancer, African American women were more likely than
white women to go untreated by physicians and to be treated by non-
surgical methods.8

For low-income women running single parent households, the above

considerations are real barriers to receiving full treatment and to surviving
breast cancer. Click here to learn more about available treatments.

More studies of breast cancer treatments are urgently needed, especially of

African American women, to make sure that these treatments are equally
effective in this community. There must be increased access to appropriate
prevention, detection and treatments for African American women.

Advocacy Groups

National Black Women's Health Project

http://www.nationalblackwomenshealthproject.org/
1211 Connecticut Ave. NW Ste. 310
Washington, D.C. 20036
(202) 835-0117
A national grassroots advocacy organization with local chapters and self-help groups.

African American Breast Cancer Alliance

P.O. Box 8981
Minneapolis, MN 55408
(612) 644-1224
A member supported advocacy and support group for women with breast cancer. Includes regional
and national networks.