The findings reported in this story are troubling. When it comes to survival after diagnosis, black women with ADVANCED breast cancer are living no longer than they did nearly two decades ago (as of 2003). White women with advanced breast cancer have been enjoying improved survival over the same nearly two decades.
Many different factors contribute to white women living longer than African American women after an advanced breast cancer diagnosis. For instance, other research has suggested that breast cancers in African American women are biologically different than breast cancers in white women. This means that the genetic makeup of the cancers is different. These differences can result in more aggressive cancers that are harder to treat. Doctors may need to consider and research different approaches to breast cancer treatment for black women.
However, some of the difference in outcome is undoubtedly the result of problems with timely access to breast cancer diagnosis and treatment among African American women. A 2006 study showed that black women have less frequent mammogram screenings, a longer follow-up time after an abnormal mammogram, and delays and other differences in diagnosis and treatment.
EVERY woman with breast cancer — no matter her age, height, weight, ethnicity, or medical history — is unique. And the same is true of every breast cancer. While we can’t change the biology of breast cancer in any one woman, we should be able to do better addressing the access and timing problems of screening, diagnosis and treatment. A good place to start is with screening, since breast cancer that is diagnosed early is typically easier to treat and so has the best chance of survival.
Consistent and timely screening for breast cancer, including regular breast self-exam and mammograms, is important for everyone. When you have a mammogram, make sure your doctor notifies you of the results. If not, call the office to follow up. If you're not sure about what the results mean, ask your doctor right away. If cost or scheduling problems are discouraging you from scheduling a mammogram or a follow-up visit with your doctor, ask a healthcare professional for help. You might have to work a little, but it's YOUR health and YOUR future -- so it’s certainly worth it.
This article was made possible by an educational grant from GlaxoSmithKline.
CHICAGO (Reuters) - Black women with advanced breast cancer are faring no better now than they were two decades ago despite improved survival by white women -- and the gap appears to be widening, U.S. researchers said Sunday.
Dr. Sharon Giordano of the University of Texas M.D. Anderson Cancer Center studied breast cancer survival in women between 1988 and 2003.
She found that, in general, women with advanced breast cancer were living longer.
"But when we looked separately by race, we found the improvement seemed to be limited to white patients and the survival for black patients had remained flat over time," Giordano said in an interview.
"What is really concerning to me is that the difference is getting bigger."
She and colleagues identified 15,438 patients from a National Cancer Institute database. They had a median age of 62 and were diagnosed with advanced breast cancer between 1988 and 2003.
They divided the groups into three time periods.
From 1988 to 1993, breast cancer survival was fairly close between whites and blacks, with a median survival of 20 months for white women versus 17 months in blacks.
Between 1994 and 1998, the median survival was 22 months for white women and 16 months for black women.
From 1999 to 2003, the median survival rate for white women jumped to 27 months, versus a stagnant 17 months for black women.
"The study didn't look at any of the factors that could be causing it," said Giordano, who presented her study at the scientific meeting of the American Society of Clinical Oncology in Chicago.
BIOLOGICAL DIFFERENCES?
Some researchers have suggested that biological differences may make breast cancer more deadly for black women.
A study last fall of 2,000 women by Dr. Wendy Woodward, also of the University of Texas, compared the records of black, Hispanic and white breast-cancer patients. They found the black women overall had more aggressive tumors and were more likely to die than the Hispanic and white women.
But Giordano was skeptical of the link to biological differences. "I don't really think it is any inherent difference in biology of people by race. It is more likely related to socioeconomic factors," Giordano said. "I think you could also hypothesize it could be related to access to care -- potentially differences in access to new treatment," she added.
Giordano said the next step is to determine the reasons for this increasing disparity. "Once you know the reasons, you can intervene to correct the problem."
Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, cautioned that biological differences should not be used to dismiss other contributing factors.
"My personal view is the majority of this (disparity) is related to access ... to the ability to get adequate care in a timely fashion, and perhaps some of it is related to biology," he said.
"We in this country need to do a better job of making sure that all women have better access to mammography and better access to care."
Breast cancer kills 500,000 people a year globally, according to the World Health Organization, and 1.2 million men and women are diagnosed with it annually.
It is the second most common cause of cancer death in U.S. women after lung cancer, and the No. 1 killer of women aged 45 to 55. It kills 40,000 men and women a year in the United States.
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