We know the data.
Black Breasties face different outcomes following cancer diagnoses than their white counterparts, with increased rates of more aggressive subtypes of breast cancer, like triple negative and inflammatory, and higher rates of mortality even as survival rates increase overall.
This World Cancer Day, The Peak is taking a dive into the research that examines why these disparities exist and what’s being done to improve outcomes for Black Breasties.
Examining the Epidemiology
Research on the causes of breast cancer in Black women falls behind that of white women.
To address the knowledge gap, the African American Breast Cancer Epidemiology and Risk (AMBER) Consortium pulled together data from four studies with the goal of understanding “the impact of genetic and lifestyle factors on the risk of breast cancer subtypes in African American women.”
The Consortium reviewed data from more than 20,000 African American women included in the four parent studies, including 5,700 with a breast cancer diagnosis, allowing them to “provide the largest dataset to date on the frequency of breast cancer subtypes” in Black women.
The Consortium has also enabled researchers to understand whether previous research around the epidemiology of breast cancer applies equally to Black and white patients. For example, one such study notes that the inverse association between dietary vitamin A and breast cancer observed in white populations is consistent in Black populations, while another found that increased alcohol intake remains a risk factor regardless of racial background.
Deep Dive into Ovarian Cancer Survivorship
In a similar vein, the African-American Cancer Epidemiology Study (AACES) aims to better understand the causes and prognosis of ovarian cancer in Black patients.
The second phase of the study, which began in 2020, is the first of its kind to focus on Black epithelial ovarian cancer survivors, the most common type of ovarian cancer.
In doing so, researchers hope to “[understand] factors that influence mortality to better understand why Black women experience worse survival after a diagnosis,” which can then be used to develop “strategies to reduce this racial disparity.”
Differences in Disclosure of Genetic Testing Results
Past research related to the disclosure of genetic testing results has focused largely on white populations. Researchers hoped to address this gap in knowledge by zeroing in on whether and to whom Black people disclose their results in a study published in the Journal of Genetic Counseling.
What they found was that Black women who test positive for a BRCA 1 or 2 genetic variation “were significantly less likely to disclose results to their daughters” within a year of receiving their results.
This, researchers say, “may have direct health implications to these family members” and suggest that healthcare providers “tailor discussions of disclosure … highlighting the importance of communicating positive results to certain family members.”
Breaking Down Breast Tumor Microenvironment
In an effort to understand why Black patients often face more aggressive breast cancer subtypes, a study published in the Journal of the National Cancer Institute examined the breast tumor microenvironment–or the blood vessels, immune cells, molecules, and normal cells that surround a tumor–focusing on the immune response.
What they found was “marked and consistent differences in tumor immune responses between Black and White patients,” which, they say, “indicate an immunobiological basis for [Black patients’] more aggressive disease.”
This increased understanding of the breast tumor microenvironment in some Black patients “may have clinical implications,” opening the opportunity for treatments like immune checkpoint inhibitors, a type of immunotherapy.
However, the study points out that clinical trials on immune checkpoint inhibitors currently have limited race-specific data. As such, researchers say increasing the “recruitment of racial and ethnic minorities into clinical trials is warranted to close the gaps in cancer disparities and to ensure that all groups of patients will benefit from advances in cancer therapeutics.”