Why Is Breast Cancer Mortality Higher For African-American Women Than For White Women?


Published:

NAVFAC Washington Walks for Breast Cancer Awareness

© NAVFAC, Flickr CC

White women in the U.S. are slightly more likely to develop breast cancer than black women – but less likely to die of it. There has been a 35 percent decrease in breast cancer mortality rate from 1990-2012. The breakdown by race over this period, however, shows a different story. Death rates for black women decreased by 23 percent, while the death rates for white women declined by 42 percent.

A big, but not the only, reason for this is that white women tend to more frequently get two subtypes of breast cancers, called ER-positive or HER2-positive, for which we now have very effective targeted treatments.

Black women, however, are two to three times more likely than white women to get an aggressive type of breast cancer called triple negative breast cancer, for which there are still no approved targeted treatments. Researchers do not yet know all the reasons why this is so, but are looking for answers.

Research has vastly improved breast cancer treatments and survival rates over the years, with a five-year survival rate for localized breast cancer at 98.9 percent, but the gap in mortality rates between black and white women has stubbornly persisted.

We study breast cancer, with a special emphasis on health disparities. Here are some of the trends we see.

 Chart: The Conversation, CC-BY-ND Source: SEER Cancer Statistics Review

Disturbing Numbers

First, some statistics that lay out the extent of the problem. About 1 in 8 American non-Hispanic white women, and about 1 in 9 African-American women will suffer from breast cancer in their lives.

While breast cancer is slightly less prevalent in African-American women, it is much more likely to be diagnosed at a later stage in them. About 37 percent of white patients and about 47 percent of black patients will have cancers that have spread from their breast to nearby lymph nodes at diagnosis. When the disease has spread, it typically presents a greater treatment challenge. In fact, the five-year survival rate for breast cancer patients with distant metastasis, or disease that has traveled to another organ such as the liver or bone, is 26.9 percent, as compared to 98.9 percent for those with a localized disease.

In addition, the aggressive triple negative type of breast cancer accounts for 12-20 percent of tumors in white women, but about 20-40 percent in black women. Triple negative breast cancer is particularly hard to treat because it does not respond to targeted treatments that have proven to be effective in treating breast cancers that test positive for certain receptors on cancer cell surfaces.

Internal Environment

Beyond triple negative cancer itself, there also seem to be racial differences in what we call the tumor microenvironment of the cancer cells. Tumor microenvironment is the immediate cellular environment of the cancer cells, including surrounding blood vessels, immune cells, signaling molecules and the tissue matrix that surrounds tumor cells (i.e., the extracellular matrix). Since the tumor microenvironment can affect behavior of the tumor cells and their response to treatments, these racial differences could impact tumor biology and disease progression. Studies have also uncovered racial differences in gene expression patterns of cancer cells, in which genes are over-expressed or under-expressed in the tumor cells of black versus white women.

 A triple negative breast cancer cell, showing the heterogeneity of its cells. Heterogeneity of breast cancer also poses challenges for treatment. Kevin Janes/National Cancer Institute, University of Virginia Cancer Center, CC BY-SA One of the common abnormalities found in cancer cells proliferating within tumors is that they often gain or lose stretches of DNA, which could include multiple genes, or even whole chromosomes that carry hundreds of genes. As a result, cancer cells may harbor higher-than-normal or lower-than-normal copies of genes compared to healthy cells. Daughter cells that arise from such cancer cells form a “clone of cells” that could be genetically different from other such clones within the tumor.

When this gain or loss occurs at a fast rate, it results in a tumor with astounding clonal diversity. Such tumors are more likely to harbor clones that can spread very efficiently through the body or resist treatments very staunchly, resulting in a higher risk of death for the patient. Scientists have discovered that breast tumors in black women tend to be more clonally diverse, and therefore harder to treat, than those in white women. The discovery of these biological factors is fairly recent, and research is still ongoing.

Beyond Tumor Biology

Having other diseases, such as diabetes, also could be not only a risk factor for developing breast cancer but also for poorer outcomes, research has shown.

Some statistics point to problems outside of the sphere of medicine, however.

In the U.S., about 23.1 percent of black women live in poverty, compared to 9.6 percent of white women. Studies have shown that a lack of resources makes a huge difference in survival rates, treatment responses, and progression of disease. Poor women are less likely to have good quality health insurance, to get as much information on early detection and screening, and to have access to the best health care and latest treatments.

Another factor, that is both biological and environmental, is obesity. According to the National Cancer Institute, fat tissue actually makes the hormone estrogen. Exposure to high levels of estrogen over a lifetime increases the risk of breast cancer.

Further, in the U.S., obesity is strongly linked to poverty, according to the National Institutes of Health. In other words, since black women are more likely to be poor, they are more likely to be obese – which makes them more likely to develop breast cancer.

The higher incidence of poverty among African-Americans also affects access to high-quality, timely care compared to white women.

The Search For Advances

In future years, we hope we will find specific mechanisms that explain the observed racial differences in breast cancer mortality. Eventually, we believe it will be possible to give each patient customized targeted treatments based on their genetic profile and other factors.

There are many factors that will need to be addressed to create racial equity in breast cancer outcomes. Bridging the gap will require a wide range of experts: clinicians, bioinformaticians, diagnosticians and epidemiologists from the science side, but also social scientists and public health experts. Only by joining together can we make sure that all breast cancer patients get the treatment that is best for them.

Padmashree Rida is a molecular and cell biologist with over 20 years of experience in research related to cell cycle regulation, cell polarity and cancer cell biology.

Ritu Aneja’s lab studies the many cellular differences in different kinds of breast cancer, aiming to find targeted therapies to treat the many different kinds of breast cancer. These differences arise sometimes from race, ethnicity, socioeconomic level as well as one’s personal genetic makeup.

This article was republished from The Conversation.

See also:
Top 12 Foods That Prevent Breast Cancer
What Our Breasts Are Telling Us

The Conversation

Edit Module
Edit ModuleShow Tags
Edit Module Edit ModuleShow Tags

Daily Astrology

September 25, 2018

Following last night’s dramatic full Moon, today’s emotional tenor is less conspicuous. The Aires Moon makes an early morning opposition to Mercury, which may present lingering communication challenges at the start of the workday. Double-check messages…
Edit ModuleShow Tags

Alternative Health Directory

Browse all listings »

Edit ModuleShow Tags
Edit ModuleShow Tags

Calendar

September 2018

September 23 - 25 A discipline called "Qigongology" has emerged as a result of the experimental data from modern medicine and clinical research combined into a 20 year study and...

Cost: Please see our website

Where:
Eastover Estate & Eco Village
430 East St.
Lenox, MA  01240
View map »


Telephone: 866-264-5139
Contact Name: Yingxing Wang
Website »

More information

Start date: September 23, 2018  Take your knowledge to the next level and become a holistic professional facilitating treatments with clients and/or teaching. Eight month program assists...

Cost: $1199 (Early Bird $1099)

Where:
Women of Wisdom
118 Washington Street
North Easton, MA  02356
View map »


Sponsor: Women of Wisdom
Telephone: 508-230-3680
Contact Name: Women of Wisdom
Website »

More information

Hosted by members of the Reflexology Association of NH and Renu Spa Complimentary mini reflexology sessions in honor of world reflexology week. Holistic Wellness practitioners, vendors, and...

Cost: Free

Where:
Renu Body Spa and Salon
583 Daniel Webster Highway
Merrimack, NH  03054
View map »


Sponsor: Reflexology Association of NH
Telephone: 603-234-5769
Contact Name: Andrea Montgomery

More information

Dates: September 23, October 20, November 17, December 8; 10am - 5pm Instructor: Linda Patterson, Clinical Herbalist & Aromatherapist Learn how essential oils work to heal the body, mind...

Cost: $500 plus $50 materials

Where:
12 Pelham Terrace
Arlington, MA  02476
View map »


Website »

More information

This transformational workshop for singles and couples will equip you with the awareness, tools and skills to create the connection and intimacy you desire. Register here: https://bit.ly/2MocBcv...

Cost: $147 per person

Where:
Watertown Center for Healing Arts
22 Mount Auburn Street
Watertown, MA  02472
View map »


Sponsor: Watertown Center for Healing Arts
Telephone: 508-340-0781
Contact Name: Brynn Bishop
Website »

More information

If you seek peace and happiness outside of yourself, this is a call to return home. What you think, you become, and what you seek is already within. This is a unique blend of practices for mind,...

Cost: $22 per class

Where:
Sohum Yoga and Meditation Studio
30 Lyman Street, Suite 108B
Westborough, MA  01581
View map »


Sponsor: SOHUM
Telephone: 508-329-3338
Contact Name: Ritu Kapur
Website »

More information

Show More...
Show Less...

Break emotional patterns that keep you stuck in the pain of addictive habits. Heal mental trauma through physical practices involving movement, breath, and meditation.

Where:
Yoga at the Ashram
368 Village Street
Millis, MA  02054
View map »


Sponsor: Yoga At The Ashram
Telephone: (508) 376-4525
Website »

More information

Show More...
Show Less...

What better way to end a busy day than with a little bliss. We'll support your body right where it is today and help you to open your spine to find more movement and flexibility. Begin and end...

Cost: $18

Where:
Body Love Wellness Center
484 Bedford St
East Bridgewater, MA  02333
View map »


Sponsor: Bliss Through Yoga
Telephone: 508-331-3564
Contact Name: Janice
Website »

More information

Show More...
Show Less...

Have you heard of natural birth control and wondered how that can be possible? Or are you trying to or planning to conceive? This session is for you! We’ll talk about the benefits of charting...

Cost: Free

Where:
The Democracy Center
45 Mt. Auburn St
Cambridge, MA  02138
View map »


Telephone: 617-899-7624
Contact Name: Anna Churchill

More information

Enjoy The Experience Of Being Fully Human And Transcendental With Enlightenment Transmission An Enlightenment Transmission happens when there is a connection between a person’s inner Self...

Cost: Free

Where:
Quaker Meeting House
1837 Forest Avenue
Portland, ME  04103
View map »


Sponsor: Enlightenment Transmission Foundation
Contact Name: Board of Directors
Website »

More information

With Jonathan Glass, Ayurvedic practitioner Presenting a 28-day program designed to initiate and maximize detoxification and nourishment of your body, mind and soul, inspiring results that can...

Where:
Zoom online class
Once you register, you will receive a link to the location of the Zoom class.
, MA
View map »


Website »

More information

With Carrie Rowan Wednesday evenings at 7pm, a 4-week introductory class that teaches quick energy medicine tools, mini meditations to help moms/dads and caregivers reduce stress and stay calm...

Where:
Fitzgerald Institute
Northboro, MA


Telephone: (508) 273-2610
Website »

More information

Show More...
Show Less...

Singer/songwriter Linda Marks releases her new album “Moments” at Club Passim in Harvard Square at 8 pm. Joining her will be her seven piece band. Rick Drost opens. Tickets:...

Where:
Club Passim
Harvard Square
Cambridge, MA
View map »


Website »

More information

September 27 - 30 Led by Chuck Raffoni ( E-RYT200) this sure to be unforgettable weekend is designed to allow you to experience Vermont in the beautiful transition from summer to fall. You...

Cost: $650

Where:
Good Commons
Plymouth, VT


Sponsor: Relax and Recharge with Chuck
Telephone: 978-807-3131
Contact Name: Chuck Raffoni
Website »

More information

“Reality itself is always already the case.” In every time and place, human beings have sought to grasp the ultimate mysteries of life and death. From time to time, great...

Where:
West Newton Cinema
1296 Washington Street
West Newton, MA
View map »


Telephone: (508) 650-0136
Website »

More information

The H.E.A.R.T. Program® (Health Empowerment and Real Transformation) is an innovative holistic curriculum addressing the current health crisis and epidemics of obesity, heart disease, and...

Cost: Free

Where:
Wilbraham Senior Center
45 Post Office Park, #4502
Wilbraham, MA  01095
View map »


Sponsor: Harmony Way
Telephone: 413-636-2475
Contact Name: Michelle Caron
Website »

More information

Grades 3-5 Instructor: Peyton Pugmire Spend September at Sorcery School! Students will be “sorted” into houses of their own design, create personalized wands, pen and cast rhyming...

Cost: $145

Where:
Creative Spirit
80 Washington Street
Marblehead, MA  01945
View map »


Sponsor: Creative Spirit
Telephone: 781-797-0389
Website »

More information

Daily practice for peace, healing, Christ mindedness, meditation, awakening.

Where:
Milton, MA


Telephone: 617-696-5685
Website »

More information

Show More...
Show Less...

September 28 - 30 Sheng Zhen Gong is not just a qigong practice, it is timeless wisdom that guides us to the way (dao) of life – a path to feeling liberated. It is the sacred truth of...

Cost: Please see our website

Where:
Eastover Estate & Eco Village
430 East St.
Lenox, MA  01240
View map »


Telephone: 866-264-5139
Contact Name: Yingxing Wang
Website »

More information

Special Offer - take both Simply Healing classes and save $25. Please click here to register. Many of us have some knowledge of attachments, thought forms and extraterrestrial influences....

Cost: $125

Where:
Circles of Wisdom
386 Merrimack Street
Suite 1-A
Methuen, MA  01844
View map »


Sponsor: Circles of Wisdom
Telephone: 978-474-8010
Contact Name: Cathy Kneeland
Website »

More information

Fundraiser for the Framingham Public Library Share in this extraordinary evening of spirit communication. Join Diane as she bridges the gap and connects to spirit delivering messages from...

Cost: $25 per person

Where:
Framingham Public Library
49 Lexington Street
Framingham, MA  01702
View map »


Sponsor: Friends Framingham Library
Telephone: 508-875-1918
Contact Name: Marsha Farmelant
Website »

More information

September 28, 12pm-7pm and September 29, 10am-6pm Experience therapeutic mini foot, hand or ear reflexology treatment. Your donations will benefit cancer patients associated with Lucy’s...

Where:
Heart and Soul Holistic Healing Center
North Easton, MA

More information

Bee Kind Music Class with Carrie Rowan inspires a love to music in little ones. 10am on Fridays for 8 weeks at Playtown Express in Southboro. To register call (508) 480-0022 or...

Where:
Playtown Express
150 Cordaville Road
Southboro, MA
View map »


Telephone: 508-273-2610
Website »

More information

Show More...
Show Less...

Blue Skye Wellness Presents: Essential Oils and Aromatherapy Full Day Workshop Learn how to effectively use essential oils Practice safe use guidelines Discern how to choose which oils...

Cost: $120

Where:
Lenox Community Center
65 walker Street
PO Box 98
Lenox, MA  01240
View map »


Sponsor: Blue Skye Wellness, LLC
Telephone: 413-242-4069
Contact Name: Kay Judge
Website »

More information

With Ross J. Miller, psychic healer, medium, regression therapist In this unique, experiential workshop you’ll learn how to identify your guardian angels and spirit guides by name and...

Where:
Newton, MA


Sponsor: Ross J. Miller
Telephone: (617) 527-3583
Website »

More information

Prequisite – Simply Healing Part 1 Special offer - Take two classes and save $25 - see info in link. This class continues the knowledge gained in Simply Healing - Level 1 as we...

Cost: $175

Where:
Circles of Wisdom
386 Merrimack Street
Suite 1-A
Methuen, MA  01844
View map »


Sponsor: Circles of Wisdom
Telephone: 978-474-8010
Contact Name: Cathy Kneeland
Website »

More information

With Katie Malloy Ramaci  Expand your connection to the angels by learning IET levels 2 and 3 certification. Truly move forward on your path. Learn Soulstar activation and release...

Cost: $1099 (Early Bird $999)

Where:
Women of Wisdom
118 Washington Street
North Easton, MA  02356
View map »


Sponsor: Women of Wisdom
Telephone: 508-230-3680
Contact Name: Women of Wisdom
Website »

More information

September 29 - October 5 7 individual days of immersion in the wisdom, healing and bliss on the life-changing Enlightenment Transmission Intensive in beautiful MidCoast, Maine, USA. In theory...

Cost: Sliding Scale $125-95/day

Where:
Damariscotta, ME


Contact Name: Board of Directors
Website »

More information

Learn basics of Tachyon and quantum physics. Sample the Tachyon healing and meditation chamber. Raffle and door prize.

Cost: $25 at the door or $20 pre-register

Where:
The Sanctuary for Celestial Empowerment
10 Grassmere Avenue
Suite #300
West Hartford, CT
View map »


Telephone: 860-586-8700
Contact Name: Celeste E Mattingly, LCSW
Website »

More information

There are few instruments like the Gong that can heal us through its purification properties of sound vibrations. In this energy field, the beginnings of removing all blocks can occur allowing you...

Cost: $35 early bird till Sept 25 ($40 after)

Where:
Sohum Yoga and Meditation Studio
30 Lyman Street, Suite 108B
Westborough, MA  01581
View map »


Sponsor: Sohum Yoga and Meditation Studio
Telephone: 508-329-3338
Contact Name: Ritu Kapur
Website »

More information

September 28, 12pm-7pm and September 29, 10am-6pm Experience therapeutic mini foot, hand or ear reflexology treatment. Your donations will benefit cancer patients associated with Lucy’s...

Where:
Heart and Soul Holistic Healing Center
North Easton, MA

More information

September 29 - 30 We all want to feel joy, happiness, contentment — and with the tools you get at this workshop — you can. Access and sustain a higher level of consciousness.

Where:
Boston, MA


Website »

More information

Show More...
Show Less...
Edit ModuleShow Tags
Edit Module Edit ModuleShow Tags