Closing the Gap for Women's Breast Cancer Screenings
- Comedian Wanda Sykes, who is being featured in a new Super Bowl ad for breast cancer awareness, has admitted to feeling “fortunate” that she was diagnosed with breast cancer at an early stage following breast reduction surgery in 2011. Her diagnosis led her to undergo a preventative (also called prophylactic) mastectomy.
- Research shows that although Black women are screened for breast cancer at comparable rates to white women, they tend to get diagnosed at later stages of the disease, which impacts their ability to treat it successfully.
- Cultural barriers impact patient outcomes in communities of color. Black Americans tend to carry added distrust and apprehension towards the healthcare industry partly because of a long history of unethical medical practices towards Black people. Working to overcome these barriers will help improve patient outcomes.
- Health experts recommend breast cancer screenings to begin between the ages of 40 and 45. However, women at higher risk (possess the BRCA gene mutation, which increases your chance of getting breast and ovarian cancer or have a family history of cancer may begin screening younger than 40.
- SurvivorNet experts recommend emphasizing earlier, more frequent screenings, increased access to clinical trials, and providing more access to oncologists to help Close the Gap in care.
Sykes, who shares twins Olivia Lou and Lucas Clause with her wife, internet personality Alex Sykes, addressed her decision on getting her breasts removed in a recent interview with People, telling the celebrity news outlet, “To me, it was, ‘They’re just boobs’ Do you want your boobs or your life? I went with life.”
Read MoreAdditionally, Sykes’ breast cancer journey reminds us that black women are less likely to get breast cancer than white women, however, if they do get the disease, they are 42% more likely to die from it. Breast cancer is more likely to kill Black women than American women of any other racial or ethnic background. There’s no single reason for these staggering racial disparities in breast cancer death rates. Biology and genetics play a part. These factors interact with socioeconomic issues, systemic bias, and other barriers to care to put Black women at risk for the worst outcomes in breast cancer.
Socioeconomic factors, bias and other access to care challenges play a part in breast cancer outcomes. This is something SurvivorNet experts have previously spoken to us about.
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Sykes also told People how she’s likely finish up menopause, adding, “I think I’m done with the hot flashes…and the irritability that came with it. You were just always annoyed.
“But now it’s like, I’m good. I’m feeling all right — maybe even a little sexy!”
In Novartis’ new ad campaign, Sykes is seen telling the camera, “When I was 47, I went in for a breast reduction expecting a straightforward surgery.
“I never imagined breast cancer would be lurking. It totally caught me off guard, and I’m pretty sure early detection saved my life. As an avid football fan, I know the big game is the perfect time to remind women to know their risks, get checked regularly, and encourage others to do the same.”
She also says, “Everyone is so busy paying attention to this, and paying attention to that. They are not paying attention to the important stuff that’s right in front of them. Whats up with that?”
Sykes shared the video ad in an Instagram post, writing, “Sometimes it feels like the world is out there to distract you. Look here! Wait, look there! How about looking at what’s right in front of you, like your breast health? #NovartisPartner #YourAttentionPlease.”
Super Bowl 59 will be taking place on February 9, and leading up to the big event, Novartis also took to Instagram to share the ad, writing, “#YourAttentionPlease! One in 8 women will face breast cancer in their lifetime, yet this reality often hides in plain sight —obscured by society’s fixation on #breasts as symbols.
“Let’s give breasts the attention they deserve, tune in and learn more at www.yourattentionplease.com a dedicated website with resources aimed at providing women of all ages and backgrounds information on breast cancer risks, and support around routine screenings.”
Wanda Sykes’ Breast Cancer Journey
Wanda Sykes was diagnosed with stage zero breast cancer (or ductal carcinoma in situ – DCIS) in 2011. While going for a breast reduction, tests found that she had DCIS in her left breast, CNN reported.
DCIS has two important factors: It hasn’t spread to other parts of the body, and the risk of death is essentially zero.
The mother of two shared her diagnosis on “The Ellen DeGeneres Show” after having a double mastectomy, which is the removal of both of her breasts. She also underwent reconstruction after the mastectomy.
WATCH: What happens during a double mastectomy?
“A double mastectomy typically takes about two hours for the cancer part of the operation, the removing of the tissue. The real length, the total length of the surgery, can often depend on what type of reconstruction [a patient] has,” Dr. Elisa Port, Chief of Breast Surgery at Mount Sinai Health System, previously told SurvivorNet.
Afterward, some women decide to have their breasts reconstructed and have implants put in, while others don’t have reconstruction at all.
Addressing Disparities in Cancer Care
- ‘Significant Improvement’ Needed: Leading Cancer Groups Address the Extraordinary Racial Disparities in Outcomes for Cancer Patients
- Cancer Trials Need More Black Participants; Here’s How We Can Close the Gap on Racial Disparities in Cancer Care
- Breast Cancer Thriver, Ananda Lewis, Addresses Racial Disparities In Cancer Care And The Importance Of Early Detection
- Community Engagement & Resources are Key to ‘Closing the Gap’ on Racial Disparities in Cancer Care
- How to Address Racial Disparities in Cancer Care
- Engage At The Grassroots And Invest In Education– How Merck’s Executive Director of Health Equity Is Addressing Racial Disparities In Cancer
- Black Women Die From Breast Cancer at Shockingly Higher Rates Than White Women
- Black Women With Breast Cancer Are Often Diagnosed Later & Have Lower Survival Rates: These Are a Few Reasons Why
- Earlier Mammograms for Black Women May Reduce Breast Cancer Mortality Disparity Rates By 57%; How to Screen for this Disease
It should be noted that a double mastectomy may not be the recommended treatment for others with DCIS. Choosing the right treatment is a very personal decision, and you should discuss your options with your doctor.
Although Sykes eventually went public with her breast cancer battle, it took her several months before she started telling others about it.
Her decision to wait to share such a personal health experience is completely normal, says Dr. Lori Plutchik, who also told SurvivorNet that some people feel comfortable sharing the information widely with family, friends, and others.
“Other people are much more private about it,” she says, “And there is no one right way to handle this diagnosis. People should do what feels right to them.”
In the years following Sykes’ breast cancer diagnosis, she has become an advocate for breast cancer awareness by doing PSAs promoting early detection through mammograms and self-exams. During her PSA, she announced she’s still “cancer-free.”
Closing the Gap Can Lead to Better Patient Outcomes
According to the Association of American Medical Colleges, “only 5.7% of physicians in the U.S. identify as Black or African American.” That small number fuels inequities in medicine and, if addressed, could boost the amount of trust Black Americans have in the healthcare system.
“This is the biggest factor,” Oluchi Oke, MD, a breast medical oncologist at MD Anderson Cancer Center in Houston, Texas, previously told SurvivorNet.
“With later stage breast cancer, stage 4, we have no cure for that. So, if patients are known to have later stages, compared to other populations, they are going to be more likely to experience cancer mortality.”
Josette Gbemudu is the Executive Director of Health Equity at Merck and has advocated for increased diversity in healthcare for years.
“We know that black women and African American women are disproportionately impacted with triple-negative breast cancer: high incidents, high mortality relative to other racial demographics and groups across the country,” Gbemudu told SurvivorNet when we sat down with her at an earlier American Society of Clinical Oncology (ASCO) Annual Meeting, the largest cancer conference in the world.
Although the need for more Black physicians is well known, what’s stopping more from training and entering the healthcare industry?
According to Associated Medical Schools of New York, medical schools’ “high costs” and “lack of guidance and preparation” during undergraduate studies are key barriers to entry for would-be Black and brown medical students.
The Education Data Initiative says the average total cost of medical school is $218,792, which is a steep obstacle for many students.
However, the tide could be turning just a bit because Inside Higher Ed reports, “Black [medical] students in the 2021-2022 academic year rose by 21 percent, from 2,117 to 2,562.”
Black Women & Breast Cancer Risk
It is recommended that black women begin breast cancer screenings sooner than white women.
“Black women are younger when they are diagnosed with breast cancer and have cancer at more advanced stages at diagnosis,” according to a study published in Annals of Internal Medicine. The research suggests breast cancer-related mortality can be reduced by 57% if they begin mammograms at age 40.
RELATED: Dr. Anita Johnson explains that access to care is critical.
One of the reasons Black women tend to have a more challenging time with breast cancer stems from racial disparities in healthcare.
Addressing Disparities in Cancer Care
- ‘Significant Improvement’ Needed: Leading Cancer Groups Address the Extraordinary Racial Disparities in Outcomes for Cancer Patients
- Cancer Trials Need More Black Participants; Here’s How We Can Close the Gap on Racial Disparities in Cancer Care
- Breast Cancer Thriver, Ananda Lewis, Addresses Racial Disparities In Cancer Care And The Importance Of Early Detection
- Community Engagement & Resources are Key to ‘Closing the Gap’ on Racial Disparities in Cancer Care
- How to Address Racial Disparities in Cancer Care
- Engage At The Grassroots And Invest In Education– How Merck’s Executive Director of Health Equity Is Addressing Racial Disparities In Cancer
- Black Women Die From Breast Cancer at Shockingly Higher Rates Than White Women
- Black Women With Breast Cancer Are Often Diagnosed Later & Have Lower Survival Rates: These Are a Few Reasons Why
- Earlier Mammograms for Black Women May Reduce Breast Cancer Mortality Disparity Rates By 57%; How to Screen for this Disease
“African-American women are diagnosed at the same rate as white women, yet they experience cancer mortality at a rate 40% higher than white women. And that is unacceptable,” Linda Tantawi, the CEO of The Lustgarten Foundation, which promotes pancreatic cancer research, said. Tantawi previously served as the CEO of Susan G. Komen, promoting breast cancer awareness in New York City from 2013 to 2020.
“When it comes to breast cancer, the mortality rates for African American women are substantially higher than Caucasian women,” Dr. Anita Johnson, a Breast Surgical Oncologist at Cancer Treatment Centers of America, told SurvivorNet.
“When we look at stage four, the outcomes are much worse as compared to Caucasian women. When we look at the standard of care treatment options based on stages, in some cases, African American women are not being treated with the same standard of care treatment options,” Dr. Johnson added.
Dr. Johnson points to more education, clinical trials, and increased access to care to help improve health outcomes for Black women battling breast cancer.
More on Breast Cancer Screening
The medical community has a consensus that women between 45 and 54 have annual mammograms. However, an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) is saying that women should start getting mammograms every other year at the age of 40, suggesting that this lowered the age for breast cancer screening could save 19% more lives. For women aged 55 and older, the American Cancer Society recommends getting a mammogram every other year. However, women in this age group who want added reassurance can still get annual mammograms.
Women with a strong family history of breast cancer, have dense breasts, have a genetic mutation known to increase the risk of breast cancer, such as a BRCA gene mutation, or a medical history, including chest radiation therapy before age 30, are considered at higher risk for breast cancer.
Experiencing menstruation at an early age (before 12) or having dense breasts can also put you into a high-risk category. If you are at a higher risk for developing breast cancer, you should begin screening earlier.
Breast density is determined through mammograms. However, women with dense breasts are at a higher risk for developing breast cancer because dense breast tissue can mask potential cancer during screening. 3D mammograms, breast ultrasound, breast MRI, and molecular breast imaging are options for women with dense breasts for a more precise screening. It is important to ask your doctor about your breast density and cancer risk.
Family History & Breast Cancer Risk
Although breast cancer can happen to anyone, certain factors can increase a person’s risk of getting the disease. The known risk factors for breast cancer include:
- Older age
- Having a gene mutation such as the BRCA1 or BRCA2
- Added exposure to estrogen
- Having children after the age of 30
- Exposure to radiation early in life
- Family history of the disease
Contributing: SurvivorNet Staff
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