John D. Fuller Recreational Complex

Women's Health

Studies Reveal Why Breast Cancer Hits Black Women Harder

Biology and genetics -- over and above socio-economic factors -- appear to influence how black women fare after being diagnosed with breast cancer, U.S. researchers are reporting.

One new study found discrepancies in survival rates between black breast cancer patients and their white counterparts, indicating that cancer screening guidelines may need to be revised. A second study, conducted by researchers at the U.S. National Cancer Institute, found clear genetic differences in the breast cancer tumors of black women as compared with white women. This could influence how the disease progresses and how it responds to therapy, the study authors said. These findings are in line with previous research.

"Those of us who treat breast cancer every day are well aware that African-Americans just have a more aggressive breast cancer. Stage for stage, they do worse," said Dr. Brenda J. Sickle-Santanello, senior medical director of Breast Health Services at Ohio Health and medical director of oncology at Grant Medical Center in Columbus.

"African-Americans are underrepresented in research studies. I hope this will heighten awareness to people who do the research to try and target African-American populations," she added. The new studies and other research documenting racial disparities in breast cancer are being presented this week at the American Association for Cancer Research conference on The Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved, in Atlanta. Differences in breast cancer survival rates between black and white women are often attributed to non-biological reasons, such as access to health care and various socio-economic factors. While these factors are no doubt important, a growing body of research also points to biological explanations that may account for the differences.

Black women tend to have more aggressive, estrogen-receptor-negative breast tumors that don't respond to newer hormonal therapies, experts say. They also tend to have a higher rate of lymph node involvement.

The first study, by researchers at the University of Chicago, looked at 1,246 women with stage I or stage II invasive breast cancer treated with lumpectomy and radiation.

Eight years after treatment, 84.9 percent of white women were alive and free of disease, compared to 78.1 percent of black women. Similarly, 31.6 percent of black women experienced a relapse at this point in time, versus 14.9 percent of all other women.

Current screening mammography guidelines might need to be revised to benefit black women, the authors reported.

"Maybe we should be more aggressive in general and systemic therapy, even in screening," Sickle-Santanello agreed.

The second study identified differences in the gene profiles of tumors, including those involved with angiogenesis (blood vessel development) and how tumor cells interact with the immune system. Many of the same genes are active in inflammatory diseases such as chronic colitis. Previous studies have shown a link between these inflammatory conditions and cancer.

Finally, a third study looked at whether various groups of women, including black women, were undergoing auxiliary lymph node dissection, which can indicate whether the breast cancer has spread to other parts of the body.

After plying data on close to 200,000 women, the investigators found that uninsured women were 24 percent less likely to have their lymph nodes assessed, compared to women with private insurance. Women who lived in areas with low education levels were 13 percent less likely than those from high education areas to undergo the procedure, and black patients were 10 percent less likely than white patients to have their lymph nodes accurately assessed.

Age was also a factor, with women 73 or older three times less likely to get the procedure, compared with women aged 51 or younger. Lymph node dissection is considered optional for elderly women but, even so, the researchers were surprised by the size of the discrepancy.

Overall, 11 percent of patients in the database did not undergo the procedure.

"In general, there shouldn't be a non-clinical reason that influences whether or not patients receive this important diagnostic procedure," said Dr. Michael Halpern, study lead author and strategic director of health services research at the American Cancer Society. "We don't have any idea on exactly why this happens. Our guess is that there are a number of barriers related to communication between patients and physicians."

HealthDay

Copyright (c) 2007 ScoutNews, LLC. All rights reserved.

Living Large African American Women Health Concerns

Ebony, April, 2000 by Laura Randolph Lancaster

Dear Sisters:

Things are out of control.

I don't want to sound alarmist, but, the truth is, modern Black women are in lethal danger.

This is not idle speculation. This is not exaggeration nor is it based on unfounded information. This is real. This is serious. This is something all of us--homegirls, housewives, teenagers, church ladies--need to face and deal with before it hurts or kills us. "This," Sisters, is our weight problem.

In order to deal with it, however, we have to know the facts. But let me warn you; they are not pretty. Not only are Black women twice as likely as White women to be heavy, more than half--52 percent--of African-American women are overweight, reports the Third National Health and Nutrition Examination Study conducted by the Centers for Disease Control and Prevention. When you do the math, that means approximately 9 million Sisters in America are obese.

Since, for years, health experts have been warning us that obesity not only contributes to all kinds of health problems but can lead to early death and disease, I had to wonder: Why is the weight albatross around so many Black women's necks? Why, when it comes to size, are so many Sisters living large?

There are two main reasons, experts believe. One is biological (a recent study by researchers at the University of Pennsylvania found that African-American women have slower metabolisms, burning about 100 fewer calories per day than White women). But the main, most important reason, say experts, is cultural.

"Black women simply view issues of weight differently from the way White women do ...," explain the authors of the enlightening new book, Slim Down Sister: The African-American Woman's Guide to Healthy, Permanent Weight Loss. "Chances are, when we look in the mirror, we like what we see. Several studies ... confirm that we don't view `a little meat on our hones' as a bad thing, hut White women do."

In one particularly eye-opening study, Dr. Shiriki Kumanyika, professor of nutrition and epidemiology at the University of Illinois in Chicago, discovered that almost half--approximately 40 percent--of overweight Black women considered their bodies attractive. The fact that Black women aren't obsessed with weight the way White women are, that we don't allow the media to rule our consciousness and don't need to be told that Barbie is a doll, not a goal, is so exhilarating it makes me want to stand up and cheer. A positive self-image is one of the best, most important attributes a woman can have. But, at least on the weight issue, it can be taken too far.

"As much as this high self-esteem is a good thing, it is in many ways, a drawback that can compromise our future health," explains the Slim Down Sister authors, who also share insight into why weight loss is more difficult for African-American women and share tips on how to take the best parts of Sisterhood (soul food, our positive self-image) and make them work for us, not against us. "We may be conscious of our weight--thinking somewhere in the back of our minds that we could stand to drop a few pounds. But as long as we've `got it going on' ... we really don't feel much pressure to start or stick with a get-fit plan."

Of course, getting fit is exactly what we Sisters need to do. Not because we can't live happily without being a size 6, but because we can't live healthily without being fit. What we Sisters need to understand is that obesity isn't a cosmetic problem; it's a health hazard. A serious one. Controlling our weight is not about us trying to pound our bodies into some ideal shape that exists only in 17-year-olds or with a lot of photographic retouching. It isn't about how we look; it's about how well--and in many cases how long--we will live.

Because so many of us are obese and obesity is directly linked to all kinds of serious health problems--high blood pressure, stroke, adult-onset diabetes (about 80 percent of people with this disorder are obese), osteoarthritis, cancer, heart disease--far too many Black women are not only suffering from, but dying of, these illnesses every year.

That's the bad news. The good news is that we don't have to. We can stop the frightening effects of obesity right now. We can get a handle on our weight any time we choose to, as Gladys Knight recently proved. "I was out of control," Knight says of her eating habits before she committed to taking charge of her health and her life and shed 50 pounds. Now, Knight has made healthy eating habits and exercise a crucial part of her daily life.

Like Knight, when it comes to food, we Sisters have to start placing health concerns first. We have to give up the high-fat, high-sugar diets that are making us sick in far greater numbers than our White counterparts. We have to declare ownership of our own health, our own lives.

I'm not saying it will be easy. It won't. But the task of saving our lives falls on nobody else's shoulders but our own. And we can do it if we follow the advice a ninetysomething Black woman gave me a long time ago when I asked her the secret to her long and healthy life: "Eat to live," she said, "don't live to eat."

Dispelling Myths About Mammography

The third Friday in October each year is National Mammography Day, first proclaimed in the United States by President Clinton in 1993. On this day (celebrated this year on October 19) or throughout the month, radiologists provide discounted or free screening mammograms. In 1999, more than 2,200 American College of Radiology (ACR) accredited facilities took part.

Screening mammogram plays an important role in the discovery of early breast cancer in women. Yet, African-American women are less likely to get regular screening mammogram when compared to white women. A recent study conducted by the National Cancer Institute found that African-American women are more than twice as likely as white women to die from breast cancer. There are several reasons for this disparity.
Below are some of the most widely myths held by women regarding screening mammogram and the facts that refute those myths.
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Myth: I have had one mammogram; that's all I need.

Fact: Being a woman and increasing age are the two greatest risk factors for breast cancer. According to the National Cancer Institute, a woman's chance of being diagnosed with breast cancer is as follows:
By age 30: 1 out of 2,000
By age 40: 1 out of 233
By age 50: 1 out of 53
By age 60: 1 out of 22
By age 70: 1 out of 13
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Myth: My family does not have a history of breast cancer, so I am not at risk.

Fact: While family history increases a woman's risk of developing breast cancer, about 90 percent of women with breast cancer have no family history of the disease.
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Myth: I can't feel any lumps in my breast, so I don't need to get a mammogram.

Fact: Screening mammography can reduce deaths from breast cancer from 20 to 39 percent among aged 50 and over. Screening mammography can disclose a lump up to two years before it can be felt by either a woman or her physician.
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Myth: Mammograms are painful and unsafe because of radiation exposure.

Fact: Mammogram uses less radiation that a dentist's X Ray machine. It exposes a woman to roughly the same amount of radiation encountered on a commercial flight from New-York City to Los Angeles.
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Myth: I can't afford a mammogram.

Fact: Most of the insurance companies or Medicare pay for a mammogram once every 12 months for women aged 40 and older. Yearly mammograms are covered by Medicare Part B. Women will be required to pay 20 percent of the Medicare approved amount with no part B deductible. Co-payments are typically in the range of $15 to $25.
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Sources: NCI, Ohio KePRO