Breast Cancer’s Race Problem

The more doctors learn about breast cancer, the more they appreciate that while biology and genetics are major factors, they aren’t the sole predictors of who will fare best when faced with a diagnosis. Now, in a comprehensive study, researchers at the Fred Hutchinson Cancer Research Center and the University of Washington report that nonwhites were up to 60% more likely to be diagnosed with advanced cancers than white women. The risk of a Stage IV diagnosis was highest among black women.

This pattern of diagnosis at a later stage, when treatment options shrink and are often less effective, held across all types of breast cancer–those with a variety of treatment options and those that are harder to treat. That strongly suggests that while biology and genetics contribute to a heightened risk of getting certain cancers, other factors–such as socioeconomic status, geography and limited access to good health care–may be driving negative outcomes. “These disparities have more to do with social, cultural and economic factors,” says Lu Chen, who led the study.

The researchers found that black, Hispanic and American Indian women are also less likely to receive the recommended treatment–radiation following a lumpectomy, for instance, to prevent recurrence. (Whether they were offered treatment and refused was beyond the scope of the study.)

Previous studies showed that black women are more likely to die of the disease than any other group–and the latest data makes plain that nongenetic factors may be influencing their care. It also suggests that addressing the nonmedical barriers preventing minority women from taking advantage of therapies in a timely way could potentially save lives.

–ALICE PARK