5 Takeaways from BCRF’s Webinar on AAPI Women and Breast Cancer

Breast cancer rates are rising sharply in AAPI women, especially in young women. Here’s what to know

Breast cancer is the most common cancer among Asian-American, Native Hawaiian, and Pacific Islander women, and the numbers are rising. Since 2000, rates in this population have increased nearly 50%, some of the sharpest inclines in incidence in the U.S.

To address this growing concern, BCRF recently hosted “AAPI Women at Risk: The Breast Cancer Trend We Can’t Ignore,” an informative discussion about specific risks in this community. BCRF researchers Drs. Neil Iyengar of Emory University and Scarlett Gomez of the University of California, San Francisco joined actress, producer, author, and breast cancer thriver Sheetal Sheth and BCRF team member and breast cancer thriver Sadia Haque Zapp to discuss what we’re learning about breast cancer in the AAPI population.

Here are five takeaways from their conversation. You can also watch the full webinar above and join our email list to find out about upcoming events.

AAPI women are not a monolithic group

AAPI women are a “highly diverse and heterogenous” group, says Dr. Gomez, professor and vice chair for faculty development in the UCSF Department of Epidemiology and Biostatistics. Different countries of origin have different levels of breast cancer risk, and immigrating can change that. Interestingly, it used to be that Asian-born women had a lower risk of breast cancer that increased when they came to the U.S. Now, Dr. Gomez says, “recent studies suggest the opposite.” She is leading a BCRF-supported research project called the CRANE Study to investigate why rates are increasing so drastically in Asian women.

More data will lead to better risk stratification

Dr. Iyengar said that we have seen biological differences in how cancer behaves in certain populations, like Black women, so more specific data from Asian populations can help us spot possible patterns. For example, we now know that premenopausal breast cancer is significantly on the rise in East Asia. With BCRF’s support, Dr. Iyengar and his team have studied women treated for breast cancer in East Asia and found that even if they had a normal body mass index, their fat cells in their breast tissue were often dysfunctional, similar to what is seen in Western, white populations. The findings showed metabolic-driven cancer in a group “we would otherwise not characterize as being at risk for metabolically driven cancers,” he says.

There is value in ancient wisdom and modern science

Dr. Iyengar, the co-director of breast oncology and director of survivorship services at Emory’s Winship Cancer Institute, spoke about his mother’s personal experience with breast cancer and the cultural norms that impacted her throughout treatment. “There were all kinds of issues that we dealt with,” he says, “things that our own family — despite the research that I do — telling her to do in terms of her diet and her lifestyle.” He says they often spoke about how to culturally tailor her treatment so that she could stay true to her traditions while best caring for herself. “There is a lot of ancient wisdom in terms of what we can do with our lifestyles, but there’s also science that has evolved, which can better inform how we can adapt some of that wisdom,” he adds. He says the Ayurvedic concept of balance — maintaining a healthy diet, exercising, sleeping well, managing stress — is more important than isolating any one specific ingredient, like turmeric, for example.

In AAPI populations, breast cancer is still taboo

Gomez mentioned that her grandmother didn’t even know she had breast cancer; her family managed her treatment. Keeping information like this under wraps can affect what we know about our own family history, which is crucial for risk assessment. Sheth said that she has always been vocal about her experience since her diagnosis at age 42 in hopes of educating others. “There shouldn’t be accessibility issues to this kind of information, and so that was really at the heart of why I spoke,” she says. “I didn’t really care that that was taboo. I felt like we need to kind of break the ceiling on that.” Speaking up is a powerful weapon against misinformation that can travel quickly today. Sheth recalls, for example, how frustrating it was when professionals would brush aside her lifestyle questions, saying lifestyle modifications didn’t make a difference. Zapp shared that BCRF recently launched a microsite, About Breast Cancer, to counter this type of misinformation.

AAPI women are more likely to have dense breasts, which increases breast cancer risk.

The importance of screening for breast cancer, especially in high-risk populations, cannot be overstated. Dr. Iyengar says all women should make sure their screening center is using 3D mammography, also called tomosynthesis. From there, he encourages women to consult their mammogram report to see if they have dense breasts, and if they do, ask about an ultrasound for supplemental imaging. “Especially for the Asian community, we need to be asking those questions and cognizant because most screening tests were validated in Western, predominantly white populations,” he says. “So these are important factors to be aware of.”