Less Breast Cancer

May 9, 2009 by adminclyd · Leave a Comment
Filed under: Education, Health & Fitness 

cancer_Black women have less breast cancer overall than other women. But when they get it, they get it so young, in such a virulent form, that they should start mammograms and other diagnostic exams at age 33 rather than the usual age of 40. That’s the conclusion of a study of more than 60,000 Florida women by researchers from the University of Miami School of Medicine published in the current issue of the Journal of the American College of Surgeons. ”Current screening guidelines are not sufficient in detecting breast cancer in African-American patients because the disease has already developed in so many of these women by age 40,” said Dr. Leonidas Koniaris, surgical oncologist at the UM medical school’s Sylvester Comprehensive Cancer Center, the study’s lead author.

The likelihood of finding breast cancer in black women at age 33 is the same as in finding it in Caucasian women at age 40 — one in 10,000, he said. And even when black women are diagnosed, poverty and cultural issues may prevent them from receiving the newest, best treatment, the study said. The irony is that, while black women are one-third less likely to develop cancer during their lives, when they do get it, they are 30 percent more likely to die from it, according to the study. Overall, breast cancer kills 40,000 American women each year, making it the second-biggest cancer killer after lung cancer, according to the American Cancer Society, Koniaris called for public awareness campaigns to alert black women to the problem, and said their doctors should consider using ultrasound in addition to mammograms in diagnosis because mammograms have trouble detecting it in younger, denser breasts.

Early diagnosis of breast cancer can be difficult, he said. ”A patient in her 30s who finds a lump may not get it investigated. At that age she isn’t thinking about breast cancer,” he said. “There are also cultural reasons. Some people mistrust doctors. Some in the Haitian community first see alternative healthcare workers. Also, if you’re working and you can’t get time off, you can’t get tested.” In the study, 72.1 percent of black women who had breast cancer were diagnosed before age 65, compared with only 50.3 percent among non-Hispanic white women. Also, when breast cancer was diagnosed, it had metastasized beyond the breast in 5.9 percent of black women, compared to 3.1 percent of other women. Hispanic women, on average, do better than either blacks or non-Hispanic whites, he said, but were not a major part of the study.

Koniaris said genetics could be part of the reason that black women get breast cancer earlier. The fact that they have a more virulent strain of cancer explains two-thirds of their increased mortality from it. Even when diagnosed, the study said, black women were less likely than others to undergo surgery. And even those who did have surgery had lower survival rages. Part of this is lack of access to medical care, he said. Part is that black women tend to have later-stage cancer when diagnosed. Poverty played a role. Patients in the lowest socioeconomic category were treated less frequently with surgery and had a lower five-year survival rate. The study looked at 63,472 patients with invasive breast cancer using the Florida Cancer Data System and data from the Florida Agency for Health Care Administration.

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