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COLUMBUS, Ohio – Black women are at increased risk for aggressive forms of breast cancer and have a 42% higher death rate compared to white women. Many of these same women also face increased barriers to genetic testing, including financial stress, other health concerns and minimal access to specialists who are likely to recommend risk-reduction methods, according to a study published by experts at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James.)
This study, published in the journal PLOS One, showed that Black women at high risk of breast cancer face a variety of obstacles that may keep them from care to help prevent cancer and increase the chances they’ll survive if they develop the disease. Researchers in this study share insights into the factors that contribute to racial disparities in the use of preventive measures, including genetic testing, prophylactic mastectomies and medication to thwart breast cancer.
Among their findings: Black women may be less focused on breast cancer risk as an issue to be addressed proactively; may less frequently possess information to help guide their decisions about prevention; and face more constraints when it comes to making and carrying out health-protective decisions.
“We need to recognize that the personal, interpersonal and social dynamics that Black women are experiencing that influence their ability to cope with their risk are complicated and multilayered and need to be taken into account if we’re going to empower people to do something about their risk,” said Tasleem Padamsee, PhD, lead author of the study and a member of the OSUCCC – James Cancer Control Program. She also serves as an associate professor in Ohio State’s College of Public Health.
Adds Electra Paskett, PhD, senior author of the study and a population health researcher at the OSUCCC – James, “There is a real fear among some women that breast cancer is a death sentence, and that is simply not the case. There has been tremendous progress in the early detection of breast cancers, but the key is to catch it at is earliest stages when it is highly treatable.”
Connecting high-risk women with breast cancer screening, treatment
Recognizing the complex and varied factors that prevent women from getting needed breast cancer education and screening, the OSUCCC – James created a statewide research initiative called Turning the Page on Breast Cancer. It focuses on addressing the high death rates from breast cancer among Black women in Ohio. Launched with support from Pelotonia, the American Cancer Society and Pfizer, the effort is a collaboration of the OSUCCC – James, the Ohio Association of Community Health Centers, Susan G. Komen and the North Central Region of the American Cancer Society.
Through this program, the OSUCCC – James-led team provides breast cancer education and facilitates access to risk assessment, abnormal test follow-up, genetic counseling and testing, and appropriate treatment for Black women across 12 Ohio counties.
“We know that some Black women are at higher risk for breast cancer based on the counties where they live, and we want to be very intentional about reaching these women to help them connect with appropriate screenings and follow-up care, as needed,” said Paskett, who leads the TPBC initiative and serves as associate director for population sciences and community outreach at the OSUCCC – James, where she also directs the Center for Cancer Health Equity.
Women are directed to a web-based tool where they can enter information about their personal medical history and family history of cancer to determine if they are at increased risk for breast cancer. High-risk women are then referred to genetic counseling, where they receive a tailored risk assessment and medical testing, if needed. They are then given a personalized plan for breast health and connected to resources, including patient navigators who guide them through next steps.
Overcoming cultural barriers
Breast cancer experts say overcoming cultural barriers about discussing health is a significant challenge that prevents people from getting timely cancer screenings and testing.
“In many cultures, talking about illness and family medical history just isn’t the norm. In the United States there is concept of survivorship, so there is visibility of cancers and other health conditions, but it is still a somewhat taboo topic for many people – and that prevents people from knowing their risk and taking actions to protect themselves,” said Bridget Oppong, MD, a breast surgical oncologist and deputy director of the Center for Cancer Health Equity at the OSUCCC – James. “As a medical community, we need to do better with education so that people know the benefit of testing and how it can be lifesaving, not just for themselves but also for their children and other family members.”
For Black women specifically, Oppong notes there is a higher rate of triple-negative and HER2-positive breast cancers. Both are more aggressive forms of the disease, so it is particularly important for these women to know their personal risk and get timely screenings.
Timely screening key for reducing cancer deaths
OSUCCC – James experts stress the importance of timely breast cancer screenings as a first step to reducing cancer-related deaths. They recommend women of average risk get an annual screening mammogram starting at age 40. Women with dense breast tissue or significant family history of certain cancers need to begin screening earlier.
Breast cancer screening is available at more than a dozen locations across Columbus and the surrounding communities. To learn more about breast cancer treatment and research at the OSUCCC – James, visit cancer.osu.edu/breastcancer or call 1-800-293-5066.
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