Breast cancer is a disease that affects all ethnic and socioeconomic groups,
yet it does not affect these populations equally.
Breast cancer isn’t the killer it once was—at least, not for
white women. Thanks to routine mammogram screenings and other medical
advances, the breast cancer death rate among Caucasians has fallen 43
percent since 1980. The gains, however, are far less dramatic in Black
communities, where after 40 years of steady improvement in diagnostics
and treatment options, breast cancer deaths have declined just 23 percent.
The grim reality is, today African-American women are 42 percent more likely
to die from breast cancer than non-Hispanic whites.
“Just hearing that number should send alarm bells off in every doctor’s
head!” says Torrance Memorial breast specialty radiologist
Sarina Pai, DO.
Pai is clinical co-director at the
Vasek and Anna Maria Polak Breast Diagnostic Center. Together with co-director
Julie Sim, MD, she is on a mission to raise awareness of the grim reality—both
among doctors and their African-American patients.
“As radiologists, we’re in a really unique position to lead
the charge and increase awareness,” Pai says. She and Sim see many
patients a day for breast health problems and procedures, such as biopsies.
They also regularly interact with referring physicians, oncologists, surgeons
and radiation oncologists.
She believes all doctors—but especially family physicians and OB/GYN
specialists—should assess breast cancer risk in their African-American
patients by age 30. Those at higher risk—based on family history,
genetic mutations, hormone exposure, breast density and other factors—may
need a screening mammogram, supplemental ultrasound or MRI before they’re 40.
The causes of high breast cancer death rates among African-American women
are complex and still under investigation. Mistrust of the medical establishment
in Black communities, debunked myths about African-American women being
at low risk for breast cancer, and unconscious bias influencing physician
referrals are all contributing factors.
Here are the sobering facts:
- African-American women are less likely to be diagnosed in early stages
of breast cancer, but twice as likely to die of these early breast cancers.
African Americans have a higher risk of BRCA1 and BRCA2
genetic mutations than people of western European ancestry, putting them at far higher risk
for breast cancer.
African-American women are twice as likely to have
triple-negative breast cancer, an aggressive subtype with fewer treatment options and poor survival rates.
Pai and Sim have developed a
flyer summarizing this information for distribution to patients and referring
physicians. In consultations with this population, they make sure to discuss
lifetime risk, recommend genetic testing when appropriate, explain the
increased likelihood of low-stage breast cancer leading to death, and
stress the importance of being proactive in preventive care.
“It must be understood that Black women, if we’re not careful,
are going to die from their breast cancer at a greater rate than any other
ethnicity,” Pai says. “Each step of the way, it’s important
that everyone they encounter—from the receptionist at the front
desk to the surgeon and oncologist—share a sense of urgency.”
Research shows one important factor in reducing breast cancer mortality
in general is patient “navigation.” At Torrance Memorial’s
Hunt Cancer Institute, patients receiving breast cancer care are automatically
assigned to a
nurse navigator—a personal guide to each woman’s unique diagnostic and treatment
plan. Nurse navigators help schedule supplemental exams such as breast
MRIs and ultrasounds, make appointments with oncologists and surgeons
and connect patients with nutritionists, psychosocial support groups and
wellness classes. They’re available by direct phone or email. The
free service typically continues for two years, well into recovery and
“We envelop breast cancer patients in our care,” Pai says.
“From the minute they come to us, they’ll never feel lost
– we are here to help them every step of the way.”
Self-advocacy, however, can play an important role in early diagnosis.
Pai’s message to Black women: “If you’re 30, ask your
physician about your risk factors for breast cancer. Patients at average
risk should get a screening mammogram annually starting at age 40, but
those at higher risk may need to be screened earlier. This is all part
of part of preventative health care.”
She has a message for referring physicians as well: “Be aware. Talk
about it. If you have a patient who’s reluctant to seek care, you
need to have more conversations to ensure she gets access, that the doors
are open to her, that she feels welcome and included.”
Schedule your annual mammogram today! 310-517-4709
The Polak Breast Diagnostic Center offers high-resolution 3D mammography
at four locations in Torrance, Carson, Manhattan Beach and Rolling Hills
Estates. To schedule a screening, call (310) 517-4709.
Learn More About Our Breast Diagnostic Centers