Our Promise to Black Women

When 27-year-old Shaneera made the decision to breastfeed her newly born daughter in August 2007, little did she know that decision to breastfeed would change her life. Wanting to give her daughter the gift of a good life start, Shaneera was anxious when she felt a lump while nursing. After months of being brushed off by her primary health care provider, multiple referrals to breast surgeons and misdiagnosis, she was finally diagnosed with stage three breast cancer. In less than three years, on June 23, 2010, Shaneera died of breast cancer. Her husband and now 3-year-old daughter cannot understand what happened.

And neither can we at the Black Women’s Health Imperative understand why Black women have not benefited from the progress being made in research and new technologies. Our mission in launching a new educational campaign is to raise questions, seek understanding, and call attention to what is happening to young Black women.

This is what we know.

We know that although Black women have a lower breast cancer incidence rate than other women, Black women are dying at a significantly higher rate than any other group of women. This fact is more complex than many may think. And most alarmingly, we don’t know why.

Consider these little known facts:

Breast cancer is the most commonly diagnosed cancer among Black women and the second leading cause of cancer death. In 2009, it was estimated that nearly 20,000 new cases of breast cancer occurred among Black women and of those new cases, more than 6,000 would not have a 5-year survival rate.

Among young Black women, under age 40, the breast cancer incidence and mortality rates are higher than in white women. Yet not until 2008 did researchers reveal that the Gail Assessment Model being used to estimate breast cancer risk and to select women for clinical trials was an inappropriate tool to determine Black women’s risk.

Black women are two times more likely to develop triple negative breast cancer, an aggressive form of cancer for which there are few effective treatment options. This particular form of cancer limits treatment options; and certain therapies have been ineffective in treating triple-negative breast cancer.

Black women have a lower 5-year survival rate compared to white women: 77 percent vs. 90 percent, respectively. Yet it is not clear how reduction in mortality for white women can translate to better outcomes for black women.

Although many attribute poor outcomes for Black women to lack of insurance, chronic stress, and inadequate access, researchers and clinicians are just beginning to explore “Unequal Treatment” as a major factor in racial differences in breast cancer mortality. The “Unequal Treatment” research documents that quality of care differences indeed contribute to mortality disparities.

Among these care and treatment differences are inadequate access to quality and appropriate screening mammography and clinical breast exams, delay in testing following abnormal screening results, inadequate communication regarding treatment options and side effects, lower rates of referrals for definitive therapy, reduced monitoring following treatment, and inadequate survivorship care.