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Where Racial Disparities Persist in Breast Cancer Care
BCRF takes a look at how breast cancer affects minorities—and what our investigators are doing to close gaps in outcomes
We know breast cancer has no boundaries. It does not discriminate in its reach. The greatest risk factor for breast cancer is being female—though even men are not immune. But while all races and ethnicities are affected by breast cancer, minorities encounter significant disparities in breast cancer screening, care, treatment, and outcomes compared to their white peers.
Here, we highlight how breast cancer affects racial and ethnic populations, and how BCRF researchers are tackling this problem.
Disparities in breast cancer care among people of color
While white women of European descent are more likely to be diagnosed with breast cancer, women of African descent are more likely to die from their disease. Women of African, Hispanic, and Latinx descent are also more likely to be diagnosed at an earlier age and with more aggressive breast cancer. The reasons for these disparities are complex and multifactorial, and BCRF investigators are searching for solutions to address differences in diagnoses, biology, and outcomes between white women and women of color.
Dr. Jorge Gomez is conducting studies to improve breast cancer screening adherence among Latinas and Native American women along the U.S./Mexico border, thereby reducing breast cancer deaths. His study aims to increase first-time and follow-up mammograms using a bilingual telephone-based navigation program.
Work by Dr. Jeffrey Weitzel has revealed a prevalence of BRCA mutations in Latinas. With BCRF support, he is working in collaboration with clinicians and scientists in Mexico, Latin America, and the U.S. to expand genetic testing and counseling in these communities. These efforts have led to an increase in preventive measures, such as risk-reducing surgery.
Drs. Funmi Olopade, Christine Ambrosone, Fergus Couch, and others are seeking to understand the genetic predisposition to breast cancer, particularly triple-negative breast cancer, in Black women. These studies are shedding light on screening, prevention, and treatment strategies.
Addressing access to care and insurance
While breast cancer does not discriminate, outcomes from breast cancer can be very different depending on a person’s access to quality care. According to data analysis from the Kaiser Family Foundation, people of color are more likely than their white counterparts to be uninsured. Though they make up 43 percent of the U.S.’ nonelderly population, racial and ethnic minorities account for 51 percent of the nation’s uninsured, with the highest rates among indigenous, Latin/Hispanic, and Black Americans.
Delays in diagnosis and treatment, along with interruptions or incompletion of treatment, can all negatively impact breast cancer outcomes. Women who are uninsured or underinsured are at a greater risk of experiencing any or all of these circumstances, and BCRF researchers are working to address these issues.
Dr. Dawn Hershman is focused on improving outcomes and quality of life for breast cancer patients by identifying barriers affecting treatment compliance and testing mobile technologies to improve communications between doctors and patients. Similarly, Dr. Mariana Chavez MacGregor is devising interventions to decrease treatment delays for patients with Medicaid and Medicare.
The need for more minorities in clinical trials
In the last three decades, we have seen a dramatic 40 percent decline in breast cancer deaths overall. This trend is attributed to screening and early detection, and, most notably, to the increased use of systemic therapies. But not all women benefit equally from these therapies: Black women’s breast cancer mortality rate is 40 percent higher than that of white women and the highest of all races. Without multiracial and multiethnic participation in research and clinical trials, we lose the opportunity to understand why.
Research breakthroughs can only reach patients through rigorous testing in clinical trials, but minorities represent less than 10 to 15 percent of the participants in breast cancer clinical trials. To learn more about clinical trial participation or to find a clinical trial visit BreastCancerTrials.org.
This article has been updated to reflect 2021 data and research projects.