'Know Your Girls' campaign aims to close the racial gap in breast cancer deaths
Posted October 20, 2019 4:41 p.m. EDT
Updated October 20, 2019 4:42 p.m. EDT
Raleigh, N.C. — Black women are 40 percent more likely to die from breast cancer than white women in the United States, and public health activists and cancer researchers are trying to figure out why that's the case.
The statistic has prompted Susan G. Komen for the Cure and the Ad Council to launch The Know Your Girls campaign, which aims to increase awareness about the racial disparities that exist while also trying to devise solutions.
Part of the effort is to empower black women through education and screening.
The goal of Know Your Girls is to reduce black women's mortality rate from breast cancer by 25 percent over five years in 10 target U.S. communities.
There are both racial differences and racial disparities related to breast cancer, UNC oncologist and breast cancer researcher Katherine Reeder-Hayes said in an interview with WRAL.com.
A racial difference refers to one’s risk of getting a certain cancer regardless of societal factors like access to screenings or treatment.
Different types of cancers are biologically distinct and are treated differently, Reeder-Hayes said.
Triple negative breast cancer is more common among black women, especially young black women when compared to young women of other races.
The median age of a breast cancer diagnosis for black women is 60, compared to the median age of 64 for white women, according to data from the Susan G. Komen group.
“A black woman is not more likely to get breast cancer in her lifetime than a white woman, but when she gets breast cancer, it is more likely to be a particularly biologically aggressive type,” she explained.“That’s important in understanding differences in survival of breast cancer.”
But that higher biological risk does not explain the alarming 40-percent greater mortality rate.
As researchers continue to work to explain why so many more black women are dying, many attribute it to racial disparities. A racial disparity refers to a social or economic disadvantage that affect races within society. They can have generations of effects on health and communities.
Breast cancer disparities among the black community include late-stage diagnoses, barriers to screenings and fragmented treatment among a host of other potential factors.
In a 2014 study, UNC researchers explored beliefs and attitudes about breast cancer through focus group interviews of 57 black women in North Carolina. The study found that age, race — especially perceptions of breast cancer as a “white disease” — and lack of family history contribute to perceptions of lower susceptibility to breast cancer.
Incorrect information from family, the media and health care providers can contribute to perceptions of low risk. One study participant mentioned a lack of black representation in breast cancer awareness campaigns, such as annual walks and runs.
“There’s never any black people in those pictures,” the study participant said.
Black women are also more likely to be diagnosed with more advanced stage cancer. This may have to do with screening access and one’s ability to access further testing in the case that a mammogram raises concern.
Reeder-Hayes said her research focuses primarily on what happens once a patient is diagnosed with breast cancer and how her treatment experience differs depending on her race.
Black women are less likely to receive innovative breast cancer procedures. For example, if a black woman has a lumpectomy, she is less likely to have the follow-up radiation necessary.
Researchers have not found a major disparity in access to chemotherapy according to their race, but there are disparities in long term breast cancer treatment and management. Black patients are less likely to successfully take long-term hormone regimens every day, she said.
Reeder-Hayes said there are many reasons patients stop taking hormone regimens, a major one being negative side effects like hot flashes or muscle pain. While everyone experiences side effects, they are often managed with expensive medications and treatments that some women may not be able to afford, which could be playing a role in access.
Black women are also more likely to believe their cancer is at a low risk of coming back, Reeder-Hayes said.
“If you were trying to make a decision about taking a medicine and it was causing you some side effects, and your impression was that you were at low risk of your breast cancer returning,” she said. “It would be a pretty logical decision not to take (the pills) anymore.”
Reeder-Hayes also brought up that a woman's experience in the doctor’s office and her sense of autonomy in her cancer treatment affects her likelihood to follow her treatment plan. If a black woman does not feel empowered or heard at the doctor, she is more likely to stop taking pills.
“We have some evidence, at least, that people who feel like they share the decision to use this treatment with their doctor were more successful in the long term,” Reeder-Hayes said.
While breast cancer awareness campaigns often focus on screening, Reeder-Hayes said the issue is larger.
Black women in the United States get mammograms at slightly higher rates than white women, according to Susan G. Komen data from 2015.But, Reeder-Hayes said, screening must result in complete and prompt treatment in the case of a cancer diagnosis.
“One of the things we have to do is make sure the treatments we have right now, that we know are effective, are getting to all the people who need them,” she said. “And that’s really what breast cancer disparities boil down to.”