Why Are Black Women More Likely Than White Women to Die of Breast Cancer?

PJ Hamel Health Guide
  • I subscribe to Google Alerts, a free service that e-mails the subscriber when a chosen search term appears online. This is a fascinating service; I can choose to be alerted to blogs, to news sources where my term has appeared, to anywhere on the Web… or all of the above. Check it out: google.com/alerts. It’s a neat way to read all the latest news and opinions on, say, chocolate ice cream. Or Harley-Davidson. Or breast cancer.

     

    Breast cancer alerts usually appear when a study is about to be published, or involve news that’s big enough for major media to pick up–e.g., The New York Times’ December, 2006 article on HRT’s link to breast cancer. The news is usually pretty straightforward: a new genetic link to breast cancer, a study detailing the long-term effects of tamoxifen. Sometimes, though, I run across information online that generates some initial incredulity, but then becomes… well, credible. At least enough to keep me reading. Such was the case with an article printed in The Boston Globe recently, which mentioned some traditional beliefs among some African Americans: that exposing cancer to air makes it grow more rapidly. And that young women who have surgery for breast cancer are more likely to die.

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    Really? Removing a tumor, exposing it to air, actually helps it spread? I never heard of such a thing. However, since I’m a firm believer in old beliefs having started with a basis in fact, I decided to do look into the matter further, spurred by the Globe article. And my online research eventually led to two well-known sources: Reuters news service, and the Boston’s Children’s Hospital Web site.

     

    In summary, these two sources say that Children’s Hospital’s Michael Retsky, PhD, will publish a study in the International Journal of Surgery offering a hypothesis as to why African American women are 1.5 to 2.2 times more likely than white women to die of breast cancer, despite their lower incidence of the disease. Less access to medical care may be one reason, but Retsky and co-author Isaac Gukas, M.D., PhD, a Nigerian physician, propound a different theory: more black women are diagnosed pre-menopause (average age of diagnosis: 46, vs. 57 for white women). And that pre-menopausal surgery may spark metastasis, their theory being that once the primary tumor is removed, the body signals a host of smaller tumors to grow and take its place, something that apparently happens more readily pre-menopause. To close the circle: since more African American women have breast cancer surgery pre-menopause, more are likely to see metastasis; and therefore more are likely to die.

     

    Retsky notes that their hypothesis isn’t supported by any new research; it’s based on a 2005 Italian study showing that the incidence of breast cancer recurrence in lymph-node positive, pre-menopausal women is double that of post-menopausal women. He and Gukas used that information as a starting point, and developed their theory to try to answer the question, “Why?” As Retsky notes, “Looking at what’s happening in African American women provides a research opportunity to learn how to better screen for and treat pre-menopausal breast cancer overall. There’s much to learn that might translate into improved outcomes for all pre-menopausal women.” This could this be the tiny spark that eventually lights a fire, a fire whose glow could illuminate a long-held “superstition,” and help answer the troubling question: why do more African American women die of breast cancer than their white American sisters?

     

     

Published On: March 20, 2007