Who Gets Breast Cancer and Who Survives?
Breast Cancer Is More Deadly in Minority Women
Overall breast cancer survival rates may have improved, but not among minority women: In fact, three minority groups — African-American, Native American, and Hispanic women — are all up to 70 percent more likely to die after a diagnosis than Caucasian women, according to a study at the Fred Hutchinson Cancer Research Center in Seattle. One reason is that the most incurable tumor type — triple negative — affects African-American and Hispanic women more than Caucasian women. And it's even more prevalent in young black women, says Carey. Her research shows that 39 percent of premenopausal African-American breast cancer victims have a triple-negative tumor, compared with 14 percent of all non–African-American women at any age. "We're not sure why — it may be genetic," says Carey.
Regardless of their type of cancer, minority women may not be receiving the full treatment they need. One University of Rochester study found that doctors tend to give black women lower doses of chemotherapy than they give to white women. "We believe that physicians aren't even aware that they're doing this," explains study author Jennifer Griggs, M.D. "Other surveys have found that physicians perceive African-American patients as less likely to adhere to medical advice, so they may unconsciously worry that a too-high dose will cause side effects that will discourage patients from coming back."
Minority women's cancers are also often diagnosed at a later stage, likely because they don't seek out crucial diagnostic tests: Only about 43 percent of all African-American women over age 40 reported having a mammogram in the last year, according to one recent study. "I've had minority women come into my office with huge tumors and I've asked them, 'Why didn't you come in earlier?'" says Christine Pellegrino, M.D., an assistant clinical professor at the Albert Einstein College of Medicine in Bronx, NY. "Sometimes they say it's because they didn't have health insurance, or that they're too busy working or taking care of their kids. But by and large, what's really going on is either a lack of awareness and education about breast cancer or, understandably, denial."