Scenario : The Cure Model
We consider a cohort of 45,647 women with a survival of 72.4% at 20 years. Assume that a new treatment prevents 30% of all deaths . In this simulation, we randomly removed 30% of deaths from the cohort and assumed that these women were alive at 20 years. We assume further that the time to death of women who are not cured is the same as in the absence of treatments. The three curves representing the survival experience of the untreated and treated women are presented in Fig. ac.
a Impact of 30% reduction in deaths on annual mortality rates, ER-positive patients in SEER. b Impact of 30% reduction in deaths on actuarial survival, ER-positive patients in SEER. c Impact of 30% reduction in deaths on time to death, ER-positive patients in SEER
Taking Charge: Who Gets Breast Cancer
There are no rules about who gets this disease. The two most significant risk factors are being a woman, and increasing age. However, there are other factors that may increase your risk, and some that may lower it.
The development of breast cancer may be influenced by factors that affect the levels of female hormones that circulate in your body throughout life. These factors include the age when you began your menstrual period, the number of times you have been pregnant, your age at first pregnancy, whether you have breastfed your children, and your level of physical activity.
Take Action To Change Young Adult Breast Cancer Statistics
When all young adults affected by breast cancer work together, we can raise awareness, improve our representation in research and make each other stronger. We are dedicated to these goals, working to turn our unique challenges into opportunities for shared success. Join the movement! Become an advocate for young women with breast cancer.
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Racial Disparities A Harsh Reality In Breast Cancer Care
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As the United States enters an era of precision medicine in oncology, it is important that the racial disparities that currently exist in breast cancer care do not leave certain populations behind, according to an expert.
In an interview with Healio, Naomi Ko, MD, MPH, assistant professor of medicine at Boston University School of Medicine and medical oncologist at Boston Medical Center, discussed how disparities in care disproportionately affect Black and Brown women with breast cancer, the need for better representation of these patient populations in clinical studies, ways to address these issues and more.
Naomi Ko
Healio: Are there significant differences in incidence or rates of breast cancer for Black patients compared with patients from other racial/ethnic backgrounds?
Ko: Unfortunately, when compared with other races in the United States, Black women suffer worse breast cancer outcomes. This persistent disparity has been an ongoing challenge for decades. For many years, Black women had a lower incidence rate of breast cancer, but in the last 5 years, we have seen that the incidence rate has converged and remained close but a persistent difference in mortality remains.
Healio: Are there differences in prognosis and outcomes for Black patients compared with patients from other racial/ethnic backgrounds?
Socioeconomic Disparities In Breast Cancer
Breast cancer incidence, survival, mortality rates as well as its risk factors vary not only between race and ethnic groups but also with socioeconomic status . Studies have suggested that racial disparities in breast cancer are reduced compared to the disparity observed when social and economic factors are examined alone. When socioeconomic status is considered, certain studies suggest that racial disparities in breast carcinoma are smaller than when social and economic factors are examined alone, but these disparities still persist . Socioeconomic determinants affecting disparity in breast cancer mortality involve poverty, culture, and social injustice .
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Diversity In Clinical Trials
At the 2019 American Association for Cancer Researchs annual conference, health experts agreed on one major reason behind this disparity: lack of diversity in clinical trials. Despite progress by cancer researchers, Dr. Shafiq Khan, a biological sciences professor at Clark Atlanta University, said treatments developed and approved are disproportionately tested on white people.
Since 2016, the Food and Drug Administration has approved four novel drugs for breast cancer. However, none of those clinical trials had more than 3% black participants.
Dr. Lucio Miele, chairman of Louisiana State Universitys genetics department, said the lack of diversity in drug development has two far-reaching consequences for black women in the South. First, the latest cancer therapies arent fully proven to be effective in minority populations. Second, researchers havent advanced targeted therapies for triple-negative breast cancer tumors that disproportionately affect black women.
Its always been thought that black women cant be recruited because they dont want to be, said Athena Starlard-Davenport, a genetics professor at the University of Tennessee Health Science Center. Ive found the opposite in Memphis. Black women say they want to help and help future generations but they dont always know where to go.
Until that happens, Beverly Tolliver Foringer, a senior clinical research associate with Bayer, said studies will remain narrow in their findings.
African American Women More Likely To Die From Breast Cancer
Black women are more likely to develop aggressive forms of breast cancer than white women because of genetic differences in the tumours, a new study suggests.
The finding that genetic characteristics of more aggressive tumours may be more prevalent among black women could help explain racial differences in survival rates. The researchers said their findings could help scientists develop more targeted treatments for the disease.
Previous studies have already found that, compared with white women, black women have a higher prevalence of breast cancers that do not respond to hormone therapy so-called “triple-negative” breast cancers.
Genomic differences
Now, the new study reports that black breast cancer patients also have a “significantly higher prevalence of the TP53 driver mutation, basal tumour subtype and greater genomic diversity within tumours, all of which suggest more aggressive tumour biology,” the study’s lead author, Dr Tanya Keenan, of Massachusetts General Hospital Cancer Centre in Boston, said in a hospital news release.
“The higher risk of tumour recurrence that we observed among African American women was reduced when controlling for those factors, suggesting that these genomic differences contribute, at least partly, to the known racial disparity in the survival of African American and Caucasian breast cancer patients,” Keenan added.
Read: More black women die of breast cancer
More aggressive tumours
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History Of Breast Cancer Or Breast Lumps
A person who has had breast cancer is more likely to develop it again than a person with no history of the disease.
Having some types of noncancerous breast lumps increases the risk of developing the cancer later on. Examples include atypical ductal hyperplasia or lobular carcinoma in situ.
People with a history of breast, ovarian, fallopian tube, or peritoneal cancer should ask their doctors about genetic testing.
Why Black Women Are More Likely To Die From Breast Cancer
Breast cancer is the second most deadly form of cancer in the United States for women, with the American Cancer Societyestimating that upwards of 40,000 women died of breast cancer in 2019 alone. While breast cancer mortality rates have steadily improved in recent years, overall cancer incidence among black and Hispanic people has grown. A major mortality gap has emerged between white and black women.
According to the National Center for Biotechnology Information , black women are 42% more likely to die from breast cancer than their white counterparts. This disparity is even more dramatic among women under the age of 40: the American Cancer Society found that black women have both higher incidence rates of breast cancer and double the mortality rate of white women. Although technological advancements in screening and treatment processes have improved breast cancer mortality rates on the whole, a major disparity in mortality rates remains.
Given that a multitude of research has indicated that there is a large proportion of black people living in poverty, it is evident that the risk factors produced by lower-income status is a direct factor for the mortality disparity, with distressing implications.
African American women also tend to have dense breasts, which is considered a predictor for breast cancer and makes mammograms more difficult to read, hindering early-stage detection and prevention.
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Death Rates For Breast Cancer
According to BreastCancer.org, 2,670 men in the United States are expected to be diagnosed with breast cancer this year. While this is less than one percent of women expected to develop breast cancer in the same time frame , a new study says that the men could be facing death at higher rates. In fact, Men diagnosed with breast cancer are at a greater death risk than women, according to a new study by Vanderbilt.
The study, which was published in JAMA Oncology last month, came about from 10 years worth of data. The analyzed data came from the National Cancer Database and included info from January 1, 2004 to December 31, 2014. As for who participated in this data collection, it was 1.8 million women and 16,025 men. Keep in mind, this stark difference in sample size could have affected the info provided by Vanderbilt.
The study found that men diagnosed with breast cancer had higher rates of death as a result of the disease. This was true even after factors like the type of cancer, the type of treatment, and access to care were considered. Within the studys time frame, 5 years showed this consistent difference in death rate. Within those five years, 19 percent of men were more likely to die than their female peers.
Racial And Ethnic Disparities In Breast Cancer
Asian-Americans who have recently immigrated to the U.S. show lower rates of breast cancer than those who have lived in the U.S. for many years. However, for Asian American women born in the U.S., the risk is about the same as that of White women . The breast cancer 5-year relative survival rate has increased significantly for both Black and white Women in the last 40 years. Still, substantial racial gap remains. A 5-year survival rate was observed to be 81% for Black women and 92% for White women in recent years .
Chinese and Japanese women have the highest breast cancer survival rates whereas Black women have the lowest survival rate of any racial or ethnic group . Overall, breast cancer mortality rate is still higher among Black women compared to White women and other ethnic groups . The gap in breast cancer mortality rate among Black women continues to increase. For example, a report between 2000 and 2010 indicated that breast cancer mortality increased from 30.3% to 41.8% among African American women and that at the advanced stage, 5% of breast cancers are detected among White women compared to 8% of breast cancers among Black women .
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Black Women Are More Likely To Die Of Breast Cancer Especially In The South
Breast cancer survivor Felicia Mahone, holding a photo of her and her mother, who died of breast cancer, has devoted her life to helping other women through the course of treatment.
UNION CITY, Ga. When Felicia Mahone was 27, she felt her breast and found a mass. Breast cancer had killed nearly all the women in her family her mother, two aunts and two cousins. Her doctor, though, downplayed the lump, assuring her everything would be all right.
For months, Mahone resumed her busy life. But she couldnt shake the feeling the lump might be a tumor. So she saw another doctor at Grady Memorial Hospital in Atlanta. There was more testing, and more nervous waiting. Finally, a biopsy confirmed her deepest fears: stage two breast cancer. Daunted by the prospect of facing cancer without family support, she made a vow to God: Get me through this, and Ill help others not to go through this alone.
Treatment advances have improved breast cancer survival rates among all U.S. women, but the disparity between white and black women has grown: Black women such as Mahone are 40% more likely to die from the disease than white women, according to the Centers for Disease Control and Prevention.
We automatically think that, when we get cancer, were doomed and that its a death sentence, said Mahone, referring to black women. We dont talk about cancer, dont share it, dont embrace our hair falling out, and dont want to look sick. So many other women, though, are living for years.
What Is Secondary Breast Cancer
Secondary breast cancer is when breast cancer spreads from the breast to other parts of the body, becoming incurable. Breast cancer most commonly spreads to the bones, brain, lungs or liver.
While it cannot be cured, there are treatments that can help control certain forms of the disease for some time and relieve symptoms to help people live well for as long as possible.
There are an estimated 35,000 people living with secondary breast cancer in the UK. In around 5% of women, breast cancer has already spread by the time it is diagnosed.
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Black Women Are More Likely To Die From Breast And Cervical Cancer
Black women have the highest rates of death compared to women of any other ethnicity when it comes to breast and cervical cancer. The Cennters for Disease Control and Preven-tion finds that Black and White women get diagnosed with breast cancer at the same rate, but that Black women are 42% more likely to die from it. In Florida, that number is 52% according to the Florida Department of Health. In Broward County, the number is 56%. In cervical cancer diagnoses, the 5-year survival rate for Black women is 58% compared with 71% for White women, even though it is one of the most highly preventable and treatable diseases.
Brenda August knows she is one of the lucky ones. In July 2020, the 60-year-old West Palm Beach resident saw a visible lump in her right breast. Having been laid off years prior, Au-gust had no insurance to get the lump checked. It had been three years since her last mammogram. Thank-fully, her daughter, a nurse at Found-Care in West Palm Beach, knew exactly how to help her.
Through a subsidized program by the Promise Fund of Florida at Found-Care, August got the lump examined. Promise Fund helped provide August with a mammogram, ultrasound, and biopsy of the lump. Doctors diag-nosed her with stage 2 breast cancer. A lumpectomy followed in September 2020. August has now been cancer free for more than a year.
Why Are Black Women More Likely To Than Others Die From Breast Cancer Expert Weighs In
I groan back and sometimes I do so viciously
- Joined
WhewChileTheJello said:Because of my family history whenever I have a lump that wont go away my OB sends the referral for a mammogram. I get benign cysts that come and go depending on where I am in my cycle. So I have to be extra mindful.I will say that the last person to review my scans at the place I was referred to was a bitch and I rarely use the word. It was like she was upset o was referred. Thank goodness I have a Black OB that listens and will refer me regardless if something is off. I advise woman that have lumpy boobs to not brush it off. Better safe than sorry. Keep feeling them and looking at them. Take a mirror and look underneath for any changes.
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Cosmetic Implants And Breast Cancer Survival
The general agreement, based on , is that silicone breast implants do not increase the risk of breast cancer. A 2015 meta-analysis of 17 studies that included participants who had undergone cosmetic breast augmentation discovered no increase in the risk of breast cancer associated with the procedure. In fact, the research showed that the incidence among these participants was lower than expected.
In 2021, another study found that women with cosmetic implants have significantly lower rates of breast cancer than those who do not have them.
Meanwhile, a 2013 meta-analysis found that women who received a diagnosis of breast cancer after getting cosmetic breast implants may have a higher risk of dying from the disease.
However, this research did not factor in other variables that may influence breast cancer mortality, such as body mass index, age at diagnosis, or cancer stage at diagnosis. And at least one of the studies in the analysis looked at overall mortality, instead of breast cancer-specific mortality, thereby potentially skewing the results. As such, a person should consider the finding with caution.
most common type is ductal carcinoma, which begins in a milk duct. Another type is lobular carcinoma, which begins in a lobule, one of the tiny glands that produce milk.
Invasive breast cancer involves cancerous cells spreading to nearby tissue. It is then more likely that the cancer will spread to other parts of the body.
Still Lots Of Questions
Dr. Joanne Mortimer, vice chair and a professor at the City of Hopes Department of Medical Oncology & Therapeutics Research, told Healthline a lot more information is needed.
They adjusted for age, race, and stage, but they didnt adjust for socioeconomic factors their access to care, insurance, their ability to make appointments all play into the outcomes as well, Mortimer said.
This is really important because poverty is a major cause of doing badly with any cancer. And if its disproportionate in Black women, which we dont know from their data, that would contribute as well, she added.
Then theres biologic factors that they did not include in this. They did not include the type of breast cancer, she said. African American women in this country have a disproportionate amount of triple-negative breast cancer that has a much worse outcome.
So, I think the lack of the type of breast cancer and the lack of socioeconomic data really hamper drawing a lot of conclusions from this paper, she added.
Blanter said she and her colleagues believe their study should prompt more research.
We think our study opens the door for a lot of future projects, the most important of which is finding the source of the continued existing disparity, she said.
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