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Karen Harris is a clinical nurse educator at Robert H. Lurie Comprehensive Cancer Center (RHLCCC), Northwestern Medicine in Chicago. Karen transitioned to nurse educator after many years of working as an infusion nurse. Her strong desire to teach led her to her current role, educating and mentoring new nurses entering the oncology field. Karen was instrumental in the development of the first preceptorship program at RHLCCC to develop high-level oncology nurses. Karen also chairs RHLCCC’s Best Practice committee, ensuring evidence-based practice across the cancer center.

African American Women Aren't Receiving the Benefits of Breast Cancer Awareness

Despite advanced technology and new treatment breakthroughs in cancer care, treatment disparity remains among African American women with breast cancer.
 
PUBLISHED: 8:24 PM, THU OCTOBER 24, 2019
October is recognized as Breast Cancer Awareness month, and it is difficult not to notice the theme at every turn, from worldwide landmarks with pink lights—Buckingham Palace, the White House, and Tokyo Tower, to name a few—to professional athletes altering their uniforms with pink socks, sweatbands, and caps. During this month, you can also find seminars, conferences, and screenings centered around breast cancer. Advertisements on television and social media, too, are loaded with the color pink and the symbolic pink ribbon.

Despite all these efforts to bring awareness to breast cancer, as an African American woman, it is heartbreaking to read the statistics about my ethnic group and the treatment disparity that still exists in 2019. A Cancer Journal for Clinicians reports that among African American women with breast cancer younger than 50 years old, they have a mortality rate double that of white women with breast cancer.1

Not only are more aggressive forms of breast cancer diagnosed in African American women than white women2—such as triple-negative breast cancer (TNBC), which has limited treatments available and can’t be treated with hormonal therapies—but the disease is being diagnosed at more advanced stages. Contributing factors to these inequalities include social and economic disparities, cultural differences, biological differences, and lack of access to high-quality healthcare. The socioeconomic disparities stem from fewer opportunities and lack of access to resources, such as employment, income, education, housing, healthy foods, and standard of living compared to white Americans. The higher cancer burden may also reflect different rates of behavioral risk factors for cancer such as smoking.3

Are we looking close enough at the biological differences? Why are black women more opt to develop TNBC that is most likely not due to a BRCA1 mutation?4 Does socioeconomic status determine the type of breast cancer diagnosed in these women? Could there be a gene mutation expressed in black women that has not yet been identified? In order to dive further into the germline DNA, clinical trials need to include more African American women.

With what we already know, how can we begin to close this disparity gap? I believe knowledge is power and without knowledge, life is lost. Education is key to closing this gap. The American Cancer Society has done a lot of work to bring awareness to underserved communities through prevention and early detection programs and services, by providing transportation to treatment and lodging during treatment, and by assisting with navigation through the healthcare system.3 Community leaders, cancer advocates, health care workers, organizations, associations, and anyone who has an interest in the community must join forces to help bring their own awareness to the unique challenges that African American women with breast cancer face.

The technology is available, and new breakthroughs and treatments are continuing to be revealed, but African American women are not receiving many benefits from these advancements. Much work is still needed to improve the mortality rate and close the disparity gap of African American women with breast cancer.




REFERENCES:
  1. DeSantis CE, Ma J, GHaudet MM, et al. Breast cancer statistics, 2019 [published online October 2, 2019]. CA Cancer J Clin.  doi: 10.3322/caac.21583.
  2. Forster V. Breast cancer death rate continues to drop, but black women have far higher mortality rates. Forbes. October 2, 2019. forbes.com/sites/victoriaforster/2019/10/02/breast-cancer-death-rate-continues-to-drop-but-black-women-have-far-worse-chance-of-survival/#681548922054. Accessed October 18, 2019.
  3. American Cancer Society. Cancer Facts & Figures for African Americans 2019-2021. Atlanta, GA: American Cancer Society; 2019. cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/cancer-facts-and-figures-for-african-americans/cancer-facts-and-figures-for-african-americans-2019-2021.pdf. Accessed October 18, 2019.
  4. The biology of cancer health disparities. National Cancer Institute website. cancer.gov/research/progress/discovery/biology-cancer-health-disparities. Accessed October 18, 2019.


Talk about this article with nurses and others in the oncology community in the General Discussions Oncology Nursing News discussion group.
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