Higher rate of aggressive breast cancer among Black women

By Pat Watson Wednesday October 09 2013 in Opinion
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Who would have thought that a significantly high percentage of Black women in North America share something in common with A-list movie star Angelina Jolie? During the summer the Hollywood actress went public about her decision to undergo surgery to remove her breasts as a preventive measure against the same cancer from which her mother died. Jolie carries a genetic mutation – BRCA1 – that increases the possibility for developing breast and ovarian cancer.


Until recently, the reason for Black women in this part of the world being more susceptible to aggressive breast cancer tumors and higher rates of death from this type of cancer was not fully understood, but more information is coming to light through genetic research.


A study done in Chicago not too long ago found a relationship between BRCA mutation in families of Black women with high rates of cancer-related deaths. There are few available statistics for Black women in Canada, however if we parallel the rates in the U.S. then the findings are that older Black women are diagnosed with breast cancer at a lower rate than the general population and die from this particular type of cancer at a rate more than 40 per cent higher.


Statistics also reveal that breast cancer occurs in younger Black women at a higher rate than the general population. So it should not be assumed that this is a concern only for older women because even among Black women who have not yet entered the menopause stage the occurrence of breast cancer is higher than the general population.


Women who have a family member who has had breast cancer should be very vigilant about monitoring breast health. However, that does not mean everyone else is risk free. Even if there is no history of breast or ovarian cancer in the family, again because of the higher rates in this community, it is prudent to maintain a program of regular checks as a preventive practice.


Other considerations to keep in mind include whether puberty began before age 12 as well as whether menopause occurred after age 55. If a woman has no children or had children after age 30 it is important to monitor for any changes in her breasts that might indicate the presence of a tumor. Being overweight and having a diet high in fat are also considered connected with the onset of cancerous tumors. And, yes, living with poverty is also considered a contributing factor, whether because of health-related stress, poor diet or less access to proper medical care.


Yet, regular mammograms are not without controversy. As recently as a couple of years ago, oncology researchers in the U.S. and also in Canada were recommending women have fewer mammograms. The reasoning was that the tests can be inaccurate and that false positives can cause needless distress for women. There are also concerns that the tests could trigger cancer resulting from exposure to radiation that is used in taking the pictures for the tests, which are recommended annually.


Anyone who has ever had a mammogram would understand that concern as well as the discomfort that comes with the clamping and setup procedure for the pictures to be taken.


Nevertheless, for Black women there is another important concern, which is the bias toward lower care within the medical profession. What this means is that we must take a more active role in ensuring that every necessary part of care is carried out. It means learning to ask the right questions of our medical professionals who are often reticent to disclose full information to a patient unless they are thoroughly questioned. Or, they many use medical jargon that most non-medical persons would not easily follow. Ask until you feel that you thoroughly understand what your condition is, what procedures are necessary and what is expected of you, as the patient, to ensure your health. Ask if every test that can be taken has been taken. Ask about follow up. Ask about second opinions. Learn how to do regular monthly breast checks and be mindful of any changes that you observe.


It is better to know what is happening as soon as possible in case a tumor should occur because hoping it will spontaneously disappear is not an effective treatment. Such miracles are extremely rare.


A note on the never-ending story…


Another week, another provocative news report about Toronto’s beleaguered mayor. One can argue that no one has found anything definitive with which to charge Rob Ford, but there’s an awful lot of smoke clouding his circumstances.


Pat Watson is the author of the recently published ebook, In Through A Coloured Lens.


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