Breast cancer doesn’t care whether you’re rich, poor, old or young. But certain communities seem to be hit harder by the disease — like African-American women.
Overall, even though Caucasian women are slightly more likely to develop breast cancer than African-Americans, according to the American Cancer Society, African-American women are more likely to die of the disease.
The survival rate is 80 percent for African-American women, compared to 90 percent for women of other races. And breast cancer is more common in African-American women at a younger age — under 45 years old.
So why the higher mortality rate? “We used to think it was poverty and a lack of access to healthcare,” says Dr. Katherine-Ann Joseph, an assistant professor of surgery at New York University Langone Medical Center and NYU Cancer Institute.
“Those are important issues that still need to be addressed — socioeconomic factors still play a role in affecting early detection. But we’re starting to find [that] the tumors many African-American women get are simply more aggressive.”
African-American women have the highest incidence of an aggressive type of breast cancer called triple-negative breast cancer, which accounts for about 10 to 20 percent of all breast cancer cases nationally.
“It’s not new and solely unique to African-American women — it’s just that more African-American women tend to get it,” says Joseph.
Any breast cancer tissue that is removed is tested for three receptors — estrogen, progesterone and a protein called HER2/neu — all of which are known to fuel breast cancer tumors.
“These are important because they play a role in how we treat women after surgery,” explains Joseph.
However, triple-negative breast cancer doesn’t test positive for any of these receptors. “If a tumor is negative for all three, we can’t give the patient Tamoxifen, for example, which is an anti-estrogen therapy,” she says. “And we can’t offer Herceptin, a monoclonal antibody that blocks the HER2/neu receptor. It cancels out the other options.”
That means you’ve got an aggressive form of cancer with fewer treatment options to beat it; patients with triple-negative breast cancer are often just left with chemotherapy.
Delay in early detection also hurts all women’s chances of catching cancer in its more treatable stages.
“There’s a fear about cancer that many women face, but African-American women still have a feeling that cancer is a death sentence,” says Joseph. “There are still a lot of myths that circulate that once the knife touches the cancer, it’s going to spread. If you can catch cancer early, [though], obviously your survival [rate] is going to be better.”