by Jeffrey Brown, MD
Breast cancer in African American women is something we can't afford to stop talking about. In 2009, an estimated 40,170 women will die from breast cancer. Nearly 6,000 will be African-American women. You do the math. African American women make-up roughly about 7% of the U.S. population but account for 15% of the deaths from breast cancer every year.
It's been estimated that African American women ages 35 to 44 have a death rate from breast cancer twice that of white women the same age. The chart below shows how many deaths are caused by breast cancer per 100,000 by race and age.
Notes
*Includes Alaska Native; **includes Pacific Islander
Source: Office Of Minority Health Resource Center
Credit: Alyson Hurt
Black women in their twenties to fifties are twice as likely to die of breast cancer as white women who have breast cancer. About 33% of African-American women who get breast cancer are younger than 50 years old.
Part of the reason for this difference may be due to that fact that studies have estimated that 20 to 30 percent of breast cancers in African-American women are triple-negative breast cancers. Triple-negative breast cancers lack estrogen, progesterone, and HER-2 receptors. Typically these receptors are found on breast cancer cells and are used by drugs/ chemo to target and kill the cancer cells. Obviously if cancer cells don't have these receptors they won't respond to many available drug treatments known to block the cancer's growth. Genetics are likely behind this difference, but no one knows for sure.
Additionally, some studies suggest African American women don't get screened for breast cancer as early and as often as white women, and aren't being referred to specialists in a timely fashion. Some studies also suggest that the difference in death rates may be due to black women in America experiencing more stress than whites, but this factor has yet to be fully explored.
Taking all these factors into account and in lieu of the Task Force's recent new recommendation of not starting screening mammograms until age 50, one could easily conclude that a lot of African American women are being missed as it relates to early diagnosis and treatment of breast cancer. This also suggest that there should be consideration made for creating separate guidelines for African-American women other than the task force's recommendation of starting at age 50.
As a physician, I'm still recommending that black women, and all other women for that matter, continue getting screening mammograms starting at age 40, or even sooner in African American women who may be at higher risk. The key message here is that you must take charge of your own health. Don't expect or wait for someone else to do it for you. It may be too late if you do.
You can click on this link to download an excerpt from my new book Health Power 101: the Complete Guide to Patient Empowerment to learn more about keeping track of your mammograms and other important health screening tests.
Live long and live well,
Dr. Jeff Brown
www.jeffreybrownmd.com
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