Breast Cancer Across Race and Ethnic Groups

October 9, 2013
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October is breast cancer awareness month. Recent reports show that its impact crosses race and ethnicity with major disparities still prevalent.
October is breast cancer awareness month. Recent reports show that its impact crosses race and ethnicity with major disparities still prevalent. Photo Credit: bigstory.ap.org

October is Breast Cancer Awareness Month, and with it comes a flurry of new reports that address breast cancer across race and ethnic groups.

An estimated 232,340 new cases of invasive breast cancer and 39,620 breast cancer deaths are expected to occur among U.S. women in 2013, according to an American Cancer Society October 1 report.

"Historically, white women have had the highest breast cancer incidence rates among women aged 40 years and older. However, incidence rates are now converging among white and African American women, particularly among women aged 50 years to 59 years," notes the report.

According to the report, "Breast cancer death rates have dropped by 34 percent since 1990 in all racial/ethnic groups except American Indians/Alaska Natives. Nevertheless, survival disparities persist by race/ethnicity, with African American women having the poorest breast cancer survival of any racial/ethnic group."

The report also found continued disparities in screening, noting "African American women have remained more likely to be diagnosed with regional and distant stage breast cancers compared with white women," which the authors say may reflect differences in the quality of screening and delayed follow-up.

A Philadelphia Children's Hospital report in July 2013 had examined the extent of the differences in 5-year survival rates among black and white breast cancer survivors and concluded "it may be difficult to eliminate the racial disparity in survival from diagnosis unless differences in presentation can be reduced. There is also a disparity in treatment, with blacks receiving treatment inferior to that received by whites with similar presentation."

And a September report from Cleveland's Case Medical Center found that many older (65+) women with newly diagnosed breast cancer have difficulty accomplishing normal day-today tasks, but African-American women were "four times as likely to have functional disability compared with Non-Hispanic White women."

"These findings have implications for cancer treatment decision-making since optimum functional status is a key factor considered in treatment selection," said Dr. Cynthia Owusu, adding that "older African-Americans, may be less likely to tolerate standard treatment and therefore interventions ought to be developed to improve their physical function."

Among the other new studies are some that reiterate an April 2013 Fred Hutchinson Cancer Research Center report that found breast cancer survivors are among those who benefit the most from regular physical activity. In fact, women who "engaged in at least an hour of vigorous physical activity every day had a 25 percent lower risk for breast cancer, and those who walked for at least seven hours a week had a 14 percent lower risk for breast cancer, in this study of 73,615 postmenopausal women," according to an October 4 American Association for Cancer Research report. That study also found that women who walked for at least seven hours a week had a reduced risk for breast cancer.

"We were pleased to find that without any other recreational activity, just walking an average of one hour per day was associated with lower risk of breast cancer in these women," said Dr. Alpa Patel of the American Cancer Society.

While the American Cancer Society recommends that survivors exercise moderately for at least 2.5 hours per week, few women – especially older women – meet these exercise recommendations after being diagnosed, an October 1 report from ProMedica Cancer Institute found easier Nia exercise has unexpected benefits for breast cancer patients. The study found Nia - which incorporates diverse "sensory-based" movement styles from martial arts, jazz, yoga, and contemporary dance - greatly reduced fatigue in patients receiving radiation therapy and restored greater mobility in their arms and shoulders.

Finally, while past studies have suggested that women who have multiple children actually reduce their risk of breast cancer by breastfeeding, an October 1 report from the University of California's San Diego School of Medicine found it doesn't pertain to "women of Mexican descent with more children and those who breastfeed are more likely to be diagnosed with an aggressive form of breast cancer."

"This was quite surprising. No other study has seen this correlation before. Most studies show health benefits of breastfeeding," said Dr. María Elena Martínez of UC San Diego and co-director of the Reducing Cancer Disparities research program.

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Common Ties That Bind