By: Imani Brooks

October is National Breast Cancer Awareness Month. It began in 1985 and has since grown to include a host of fundraisers, pink-ed out outfits, and survival stories to advance research and awareness. However, what’s often unknown is the fact that this disease is not only the most common cancer in the world, but is 40% more likely to kill Black women than white women.

The Know Your Girls campaign, which promotes personal stories from breast cancer survivors who are Black women, aims to increase awareness of this disparity. Their goal is to reduce the current number of breast cancer deaths by 50% in the United States by 2026. So far, the breast cancer death rate has dropped by 38% due to awareness and treatment.

Know Your Girls develops print, television, and digital opportunities for Black women to learn about their bodies and risk factors like age, genes, exercise, alcohol, health history, breast density, age of first period, and breast changes. Their outreach focuses on Black women around 30-55 years old. One of their online resources is a tip sheet for how to be your best advocate at the doctor’s office.

Before and after a diagnosis, the campaign encourages women to ask questions and engage in genuine conversations with clinicians. Know Your Girls also engages celebrities, experts, clinicians and real people with clear, jargon-free language every Monday on the Instagram TV show, In the Company of Friends, which can be found @VanessaeBellCalloway and @KnowYourGirls. 

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Terri Hall, an African-American public education professional in Georgia, is a cancer survivor who credits “knowing her girls” for being here today. She was diagnosed at Stage 0 in July 2016. Hall was diagnosed after a yearly mammogram led to more biopsies and a surgery in October 2016. Given that she did not have a family history of breast cancer and she received yearly mammograms, Hall was surprised by her diagnosis. She was very lucky to have caught the cancer early. Early detection and treatment are considered to be the best defense mechanisms against a deadly prognosis.

Hall’s treatment included MRIs, radiation, and then surgery. She did not face any obstacles medically, but her mental health struggled during and after the treatment. On top of the cancer, her mother passed away earlier in 2016. Counseling helped with the psychological effects of cancer as well as with the difficulties of dealing with her mother’s passing as well. Nonetheless, she found it hard to complete counseling and treatment at the same time. Her support system of family members helped her tremendously. 

Three years later, Hall has become comfortable telling her story. Now, she values preventative care and educating herself on her own health. The slightest indicator encourages her to go to see the doctor. Based on her story, Hall tells other women to get yearly mammograms and check-ups because it can find the cancer at stage 2 or 3, as opposed to later stages that are more dangerous. She also advocates for counseling during the treatment process because thinking about death is inevitable and having professionals help cope with those thoughts is important. Hall also visits Sisters By Choice and Piedmont Cancer Center to stay educated about the disease and to serve as a mentor in support groups.

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One part of Hall’s story is early detection and treatment. Knowledge about breast cancer can be traced to Ancient Greece. According to Healthline, surgical exploration with breast cancer began in the late 1880s with the first radical mastectomy, which became the standard operation for breast cancer until 1932. Radium was discovered in 1898 as being useful for cancer treatments. In 1937, radiation therapy with surgery was deemed a viable option for sparing the breast. The first medication for breast cancer, Tamoxifen, was approved to be prescribed in 1978. And now, twenty years later, doctors have started to use tumor suppressor genes and focus on blocking the production of estrogen to treat breast cancer patients. With these medical and technical advancements, treatments have become more and more personalized. 

The American Society of Clinical Oncology identified various treatments and lifestyle choices to survive cancer or lower the risks based on research studies. The early 2000s revealed that high-dose chemotherapy with stem cell transplant does not help with breast cancer survival. Rather, researchers found that higher density, shorter term chemotherapy was more successful at improving breast cancer survival.  The Journal of the National Cancer Institute published that a low-fat diet and regular exercise may help prevent recurrence in 2005.[3] Then, in 2007, researchers from the National Cancer Institute linked a lower use of hormone replacement therapy to a decline in breast cancer diagnoses.[1]

However, none of those findings respond to the disparity of breast cancer incidences between Black and white women. Yet, the Know Your Girls campaign finds that it is important to focus on Black women with breast cancer to reduce overall breast cancer deaths in the US.

Researchers at the University of Washington School of Medicine studied the differences in quality and timeliness of care as major contributing factors for the racial disparity in breast cancer detection.[2] The retrospective cohort study includes 400 female patients who were diagnosed with breast cancer during 1985-1993 and were followed until June 20, 2011. The experimental design includes matching three random white patients to a black patient according to their year of diagnosis.

The results saw racial differences at each step of the evaluation and treatment path. One finding is that Black women are more likely than White women to be diagnosed after a patient-noted abnormality. In addition to that disadvantage, Black women are less likely to even complete a diagnostic evaluation within 30 days of finding an abnormality, increasing their risk. They are also less likely to complete any treatment within 30 days of diagnosis. Other findings were that “Black American women have shorter survival times [and]the highest rates of breast cancer mortality.”[2] 

Know Your Girls, Terri Hall’s story, and cancer research highlight October as not only National Breast Cancer Month, but as an important month for improving Black women’s health. Therefore, this month should focus advocacy around Black women to lower breast cancer deaths overall. And, if they are diagnosed, doctors should be familiar with the special needs of Black women to reach remission. Black women need investors in their health from the medical, clinical, educational and psychological viewpoints of breast cancer. It is time to advance treatments for Black women and White women to have the same incidence rate as well as the same death rate.

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References

  1. Glass, Andrew, James V. Lacey, J. Daniel Carreon, Robert N. Hoover, Breast Cancer Incidence, 1980–2006: Combined Roles of Menopausal Hormone Therapy, Screening Mammography, and Estrogen Receptor Status, JNCI: Journal of the National Cancer Institute, Volume 99, Issue 15, 1 August 2007, Pages 1152–1161, https://doi.org/10.1093/jnci/djm059
  2. Elmore, J., Nakano, C., Linden, H., Reisch, L., Ayanian, J., & Larson, E. (2005). Racial Inequities in the Timing of Breast Cancer Detection, Diagnosis, and Initiation of Treatment. Medical Care, 43(2), 141-148. Retrieved from http://www.jstor.org/stable/3768264
  3. Chlebowski, Rowan George L. Blackburn, Cynthia A. Thomson, Daniel W. Nixon, Alice Shapiro, M. Katherine Hoy, Marc T. Goodman, Armando E. Giuliano, Njeri Karanja, Philomena McAndrew, Clifford Hudis, John Butler, Douglas Merkel, Alan Kristal, Bette Caan, Richard Michaelson, Vincent Vinciguerra, Salvatore Del Prete, Marion Winkler, Rayna Hall, Michael Simon, Barbara L. Winters, Robert M. Elashoff, Dietary Fat Reduction and Breast Cancer Outcome: Interim Efficacy Results From the Women’s Intervention Nutrition Study, JNCI: Journal of the National Cancer Institute, Volume 98, Issue 24, 20 December 2006, Pages 1767–1776, https://doi.org/10.1093/jnci/djj494

*Terri Hall is the author’s chapter advisor for the Omicron Xi Chapter of Delta Sigma Theta Sorority, Inc. Soror Brooks would like dedicate this piece to Ms. Hall and Ms. Gail Snell, another chapter advisor who is a breast cancer survivor. The Redz Go Pink!

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