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Black Women Fare Worse With Breast Cancer

Many Clues But Few Answers

POSTED: 11:32 am EDT October 8, 2007
UPDATED: 11:23 am EDT October 9, 2007

Venatia Gilmer-Jones found a lump in her right breast while she was getting dressed for a funeral.

Her friend, Carmen K. Johnson, who also found a lump in her breast, said, "I woke up one morning and was putting on my bra and there it was."

Both Gilmer-Jones and Johnson are breast cancer survivors who are also trying to improve the outcomes for black women with breast cancer. NewsCenter 5's medical editor Dr. Timothy Johnson reported that black women typically fare worse with this disease than women of other races.

Women of color "don't get as many breast cancers. But when they do, they die at a higher rate," according to Massachusetts General Hospital's Dr. Daniel Kopans and many other breast care experts.

"I can see it in your face," said Dr. Nancy Norman, medical director at the Boston Public Health Commission. "It's the 'why'? It's the question clients ask, that black women in general will ask. It's one of those questions we don't unfortunately have the answer to."

There are no definitive answers, but there are some clues to the mystery of why black women's mortality rate from breast cancer is higher than whites'.

Some reasons are socio-economic; a lack of insurance or access to quality mammography. However research has shown that even when access is available, black women are less likely than whites to continue getting mammograms after their first one. "The failure to return frequently to screening results in African-American women having their breast cancers brought to medical attention when they're larger," said Dr. James Michaelson, a researcher at Massachusetts General Hospital.

There are also biological reasons for the disparity. Tumors in women of color are more likely to metastisize. Black women are two to three times more likely to get the types of breast cancer that do not respond well to some of the best hormone-blocking treatments that can now save so many lives. Kopans said, "If your tumor requires estrogen [to grow], then we have therapies that block the estrogen. It's the estrogen-receptor negative cancers we don't have great therapies for, so black women tend to have worse cancers and that's why they tend to die at a higher rate."

Another biological factor is vitamin D, which is formed by sunlight in our skin. Black skin contains more melanin, which blocks the sunlight, and studies show that black women have about half the amount of vitamin D in their bloodstream.

Dr. Walter Willette of Harvard's School of Public Health said, "We have done some analyses comparing African-American men and women, looking a various nutrients in the blood, and various hormones. We don't find any substantial difference, except for vitamin D.

Another factor behind the disparity in breast cancer is that when research studies are conducted, typically only about 5 percent of the subjects are black.

"Until we can get more minorities in the clinical trials, it is going to be hard to find treatments to work well for them," said breast surgeon Dr. Susan Troyan of Boston's Beth Israel Deaconess Medical Center.

Until there are more answers, Gilmer-Jones and Johnson said they will spread the message of awareness and prevention in Boston black community, using the city's Pink And Black Campaign.

The 3-year-old effort, which is strongly supported by Mayor Thomas Menino, targets women of color with information about screening and other resources that could help them detect cancer early. "Pink is not the only color of breast cancer," said Johnson. "I think 'Pink and Black' let's people know that it's everybody. We're all God's children and we're all affected by these illnesses."

Experts, including Norman said they hope that black women won't feel hopeless about the impact breast cancer could have on their lives. She said getting annual mammography and staying connected with your doctor can make a big difference, possibly saving women's lives.

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