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Health Equity Initiative

A group of BCRF-funded researchers are conducting a comprehensive study to understand what drives breast cancer in Black women

In partnership with The Estée Lauder Companies Charitable Foundation, BCRF launched the Health Equity Initiative to significantly reduce breast cancer disparities and improve outcomes for Black women by advancing personalized, evidence-based care. Understanding tumor, genetic, and environmental heterogeneity in Black women with breast cancer is key to improving the experience of Black patients, who suffer the worst breast cancer outcomes of any of the major racial and ethnic populations in the U.S.

Thanks to BCRF-supported research, significant inroads have been made in our understanding breast tumor biology, including the aggressive forms of the disease like triple-negative breast cancers that are more frequently diagnosed in Black women. We know that certain health conditions (comorbidities) such as obesity, diabetes, and heart disease, are more likely to affect Black women. These comorbidities then increase their risk of breast cancer and can adversely affect outcomes after a diagnosis.

Black women are 50 percent more likely to be obese and have a two-fold increased risk of being overweight compared with their white peers. They also have a two-fold increased risk of diabetes and are 60 percent more likely to develop or be diagnosed with diabetes after breast cancer treatment than white women. These comorbidities not only affect breast cancer outcomes—breast cancer mortality, for example, is 30 percent higher for women who are obese—but they are also known to worsen treatment side effects. Women with diabetes, for instance, have more than twice the likelihood of painful neuropathy following chemotherapy. When women experience worse side effects, they may not finish treatment as planned, leading to poorer outcomes. Finally, because Black women have higher rates of cardiovascular disease and risk factors for cardiovascular disease, they don’t always receive the best available breast cancer treatments because of associated complications.

We also know that where a woman lives impacts the healthcare they receive: Access to affordable, quality healthcare coupled with a multitude of other environmental and social determinants of health (such as economic stability and education) broadly affect health outcomes. Black women are 73 percent more likely to initiate treatment more than 60 days from diagnosis; 31 percent more likely to require longer time to complete therapy; 50 percent more likely to suffer financial toxicity; and are nearly three times more likely to not take risk-reducing anticancer medicines as prescribed. Genetic factors also influence how other factors impact breast cancer risk and outcomes. BCRF has a long track record of supporting innovative research to address these disparities.

BCRF has tapped into our wide base of breast cancer research experts and clinical trial leaders to conduct a novel and bold study on the interaction of social determinants of health, comorbidities, and breast cancer genetics in Black women. The steering committee has crafted a dynamic plan to understand how these elements intersect to impact Black women’s breast cancer risk and outcomes, which includes:

  • Constructing contemporary and comprehensive social determinants of health and genomic profiles—leveraging existing datasets to determine what elements are needed to create uniformity and to fully address the project’s goals
  • Compiling data on social determinants of health, treatment, and outcomes and conducting comprehensive tumor genomic sequencing
  • Integrating and linking datasets; conducting analysis to determine the most relevant social, clinical, and genomic prognostic features and how they intersect
  • Developing potential interventions and expanding the initiative to investigate breast cancer drivers in other populations

Health Equity Initiative Steering Committee

Chair: Lori J. Pierce, MD
University of Michigan

Christine B. Ambrosone, PhD
Roswell Park Comprehensive Cancer Center

Dawn Hershman, MD, MS
Columbia University

Co-chair: Lisa A. Carey, MD, ScM
University of North Carolina at Chapel Hill

Melissa B. Davis, PhD
Morehouse School of Medicine

Lisa Newman, MD
Weill Cornell Medical College

Subcommittee Members

Elisa Bandera, MD, PhD
Rutgers University

Scarlett Gomez, PhD, MPH
University of California, San Francisco

Julie Palmer, ScD
Boston University

Charles M. Perou, PhD
University of North Carolina at Chapel Hill

Julienne E. Bower, PhD
University of California, Los Angeles

Terry Hyslop, PhD
Thomas Jefferson University

Celeste Leigh Pearce, PhD, MPH
University of Michigan

Melissa Troester, PhD, MPH
University of North Carolina at Chapel Hill