Breast Cancer and Race

Despite several studies on breast cancer and other types of malignant cells, the association between breast cancer and race is still unknown. According to an American Cancer Society (ACS) report, breast cancer is one of the leading causes of mortality in the United States (Smigal et al., 2006). According to the survey, there is a general increase in incidence of the disease, as well as high mortality rates and low survival rates among female breast cancer patients. Furthermore, mammography screening is increasing significantly, indicating that disease prevalence remains high (Smigal et al., 2006). According to the 2006 data released by the National Centre for Health Statistics, close to 212,920 women reported new incidents of invasive (aggressive) breast cancer while 61,980 individuals reported “in situ” instances (Smigal et al., 2006). Out of these figures, 40,970 deaths were expected by the end of the years. There are, however, expectations that these statistics have reduced based on the fact that the country has seen new developments concerning cancer treatment and prevention. The section of the research reviews some of the pieces of literature regarding the relationship between breast cancer and race.

Types and Causes of Breast Cancer

Although many types of breast cancers exist, researchers argue that “in-situ ductal carcinoma,” “invasive ductal carcinoma,” and “invasive lobular carcinoma” are the most common types of breast cancers (Komen, 2017). The classification of breast cancer is based on the type of cells that the disease has affected. Based on the categorization, health professionals argue that carcinomas breast cancers cause the majority of deaths in the U.S. Other types of breast tumors include “sarcomas,” “phyllodes,” “Paget disease,” and “angiosarcomas” (Komen, 2017). Unlike other types of cancers, these less common tumors start within muscle cells, fats or connective tissues. At times a single breast tumor may give rise to a combination of different kinds of cancer. Similarly, the cancerous cells may fail to form tumors. The only difference between in situ and invasive cancer cells is that the form does not spread while invasive cells spread into nearby breast tissues.

Scientists have not been able to determine what causes breast cancer. Whatever doctors know is that breast cancer results from abnormal growth of cells. These cells are known to grow and divide more rapidly than normal cells. The cells accumulate in breast tissues to form a mass. Studies have shown instances where these cells metastasize to different parts of the body (Komen, 2017). These conditions may, however, be triggered by hormonal, lifestyle, and environmental factors. Despite the investigations focusing on the causes of breast cancer and specific developments that have taken place in the field of study, it is still not clear why people who have no risk factors end up developing cancer cells while people considered to have high-risk factor may not get the disease.

Overall, breast cancer results from complex interactions between genetic makeup and environmental conditions. Other numerous cases of breast cancer revolve around inherited genes. Medical practitioners argue that between 5% and 10% of breast cancers result from gene mutations and can be passed from generation to generation. Mutated breast cancer genes include inheritable factors 1 and 2. These inheritable conditions may increase threat to breast cancer or other cancerous cells.

Case of Breast Cancer among Races

Carey et al. (2006) identified gene expression as an essential factor that determines the type of cancerous cells in women. According to the researchers, physicians can use gene expression as an alternative method of determining the various types of breast cancers such as “human epidermal growth factor receptor-2,” “positive and negative estrogens,” “luminal A,” and “Lumina B” (Carey et al., 2006). The researcher's primary objective was to examine the commonness of breast tumor subtypes among different racial groups. The respondents were categorized according to their ethnicity and menopausal units to assess their response rate to various breast cancer subsets. Regarding the design, setting, and participants, the researchers applied immune-histochemical surrogate for every cancer cell to 496 cases of aggressive breast cancer subtypes. After the experiment, the investigators noted that premenopausal African-American women were more vulnerable to basal-like breast cancer than postmenopausal African-Americans or any of the racial groups. However, the luminal A breast cancer subgroup was less common in premenopausal than postmenopausal African-Americans. The study also demonstrated that positive and negative estrogen subtypes were constant with both race and women menopausal status. Based on the survey, Carey et al. (2006) concluded that breast tumor subtypes vary across ethnic groups and menopausal status with basal-like cancer being common among premenopausal African-American women. The researchers further asserted that the poor prognosis of African-American females might have resulted from higher case of basal-like breast cancer and lower occurrence of other types of breast tumors.

Ghafoor et al. (2003) argue that breast cancer in women is more invasive with over 600,000 deaths occurring across the world every year. The researcher indicates that cases of a breast tumor have become common in highly industrialized countries including America, Australia, and nations in Western Europe. The primary causes of the differences in vulnerability among women are social and cultural considerations. These factors make breast cancer a primary health concern for women. The aim of the study was to determine the difference in vulnerability to breast cancer cells using case studies and data collected from secondary sources. The researchers used data from the National Cancer Institute with a focus on specific ethnic groups including African-American women, whites, Indians or Alaska Natives, Pacific Islanders, and Hispanic females. It was also necessary to determine the number of deaths or mortality rates using data provided by the National Center for Health Statistics. The analysis revealed that Whites are more susceptible to breast tumor than any of the other racial group. African-Americans ranks second followed by Hispanic. The variation in cases of breast cancer is indicated in the table below.

Figure 1. Female breast cancer cases (Ghafoor et al., 2013).

Why Breast Cancer is Common in America

More recent statistics show that there are 189,910 cases of cancer among African-American Women (Komen, 2017). According to the data, African-Americans have lesser survival rates and greater death rates compared to other racial groups. Researchers argue that African-Americans are higher risks of breast cancer because they carry inherited genetic mutations that are likely to grow into cancer cells. The genetic mutations often develop into “triple negative” tumors, highly aggressive cancer cells, and other diseases that seem challenging to treat (Komen, 2017).

Mammography screening is essential for all females irrespective of ethnic grouping, social status, or political affiliation. Despite the effort of the government in lowering the costs of healthcare services, reports show that African-American females have less likely to seek for mammography screening than other racial groups (Komen, 2017). Cancer cells can be treated at an early stage before they spread to other parts of the breast but only if the is sufficient screening for the tumors and other causative agents. Different than deliberate boycotts, studies reveal some shocking fundamental reasons behind the recent increase in case of breast cancer among African-Americans.

When it comes to mammography screening, the American health policy only recognizes women who have health insurances. In 2015, for example, 31 percent of women aged between 40 years and 64 years did not have health insurances, hence could not obtain mammography screening (Komen, 2017). However, 68% of the group of women stated that the last time they received mammography screening was two years ago. The latter demonstrates the lack of motivation women have when it comes to health screening.

Apart from the health insurance, studies show that other factors contribute to breast cancer screening disparities (Komen, 2017). For example, women in the low-income category are less likely to go for such procedures because their insurance premiums cannot cover the costs. Not all Americans have access to health care centers and care providers. It is always hard locating the exact centers and specialists who can provide such services (Komen, 2017). Low level of education or lack of awareness is also another factor to consider. Most women do not take breast cancer screening seriously. They prefer going for treatment than seeking adequate preventive measures.

Research shows that Latin women compared to other American groups have lower incidences of breast cancer screening. The more moderate turn up rate for mammography screening among Hispanic or Latin women is attributed to many barriers (Komen, 2017). The first important reason is that Latin women record the lowest rate of the breast tumor and mortality rates compare to other ethnic groups including African-Americans, non-Hispanic backs, and Whites of non-Hispanic White women (Komen, 2017). Despite the perception, breast cancer death remains the primary cause of cancer death among Hispanic women. It, therefore, follows that Hispanic women should seek for mammography screening services like other racial groups. Other studies have shown that Latin females are diagnosed with more severe subtypes of breast cancer than white women. The view still points to the lower screening rates and the extended duration between first screening and subsequent checkups.

Just like the Latin Americans, the Alaska Natives and American Indian women have registers lower rates when it comes to breast cancer screening as compared to African-Americans and white women. A survey conducted on the people’s opinions about mammography screening indicates that 33% of Alaska Native women between the age of 40 and 63 years have never attended mammography screening while 66% of the women attended such services two years ago (Komen, 2017). According to the find, Alaska women who have gone for breast cancer screening do not see the importance, hence fail to attend the subsequent testing. Women who have never received mammography screening cite inaccessibility to medical health centers and physicians as the primary cause. Various studies have confirmed the view, and it is true that Native Americans always travel for longer distances to get quality mammography screening services as well as other treatments.

Finally, Asian-Americans have lower rates of breast tumor screening and higher deaths compared to native Alaskans or Native Americans (Komen, 2017). Despite the low rate of mammography screening, breast cancer is the second primary cause of death among Pacific Islanders and Asian Americans. It means that women from these races need breast cancer screening just like women from other ethnic groups.

The extent of breast cancer damage is fundamental for those seeking to pursue treatment options. Apart from the period of exposure, there are other factors considered before initiating cancer treatment (Burandt et al., 2016). The first requirement is for the physician to determine if the cancer cells have hormone receptors. Similarly, it becomes important to the doctor to ask questions about the overall health of the patient and his or her personal preferences. Such questions should also aim at determining whether or not the patient has gone through premenopausal or postmenopausal periods.

A physician must take a record of the rate at which the cells are growing (Burandt et al., 2016). Other than preventive measure, treatment of cancer is considered in the research because it reduces the number of individuals’ experiences experiencing cancers. Just like the mammography screening, treatment of cancer requires a lot of finances especially for those seeking to undergo chemotherapy procedures (Burandt et al., 2016). Therefore, only people who have sufficient funds can go for the available treatment options. Successful treatment of cancer cells means a reduction in the number of people suffering from such conditions.

According to Miller et al. (2016), technological advancements have improved how doctors detect and treat breast cancer or any other cancer cell for that matter. With such advances, breast cancer survival rate continues rising because of early detection and treatment of such conditions. According to the report released by the National Cancer Data, over 15.5 million American breast cancer patients in 2016 received adequate treatments for their conditions (Miller et al. 2016). Out of the population, only 10 percent were African-Americans with the rest of the population being non-African Americans. However, breast cancer incidences and survival rates are affected by the type of cancer, gender, and age group. The report is based on the successful case of invasive malignant.

Surgical procedures such as breast-conserving surgery, also known as the mastectomy, is commonly used in the treatment of breast cancer. A majority of patients go for mastectomy following its tumor characteristics while other patients seek for alternative therapies. The primary argument here is that mastectomy is expensive, and not all Americans can meet the operational costs. People who have medical insurance cover find the service cheaper and more efficient because the government pays part of the bill.

Even though it is a personal decision to go for cancer treatment, patients should be made aware that their participation in such programs are essential because it results in an overall reduction of the number of deaths (Miller et al., 2016). African-Americans, Hispanics, Indian Americans, and Alaska women registered lower survival rates compared to Whites. The most applicable argument as far as breast cancer treatment is concerned with the large number of whites enrolling for mammography procedures and other screening methods (Miller et al., 2016). Such activities make it possible for individuals to have a clear understanding of health needs and factors that may inhibit individual’s health performances.

Summary of the Literature Review

From the analysis of the literature, the following arguments become evident: (1) inherited gene mutation is the primary cause of breast cancer cells. Hollstein et al. (2017) argue that breast cancer genomes are stippled with modifications, and the extent of DNA sequence alterations are like to result in mutagenic processes. (2) The most common forms of breast tumors include “in-situ ductal carcinoma,” “invasive ductal carcinoma,” and “invasive lobular carcinoma” (Hollstein et al., 2017). All these diseases result from different cells and tissues. (3) Breast tumor can be prevented at an early and stage of development. The only way to stop the cells from invasive growth is by performing minor surgical procedures which means that members of the public must be tested for cancer cells. Testing involves the use of mammography screening to determine the level of damage and the possibility of removing the cancer cells (Hollstein et al., 2017). (4) Cases of breast cancer are common among Africans-Americans followed by whites. Poverty, low education, and inaccessibility to health services are the main reasons for the increase in the number of African-American with breast cancer. However, through policy developments, there will be a greater opportunity for African-Americans to explore the available healthcare services. Such benefits also narrow down to other minority groups.

References

Burandt, E., Grünert, M., Lebeau, A., Choschzick, M., Quaas, A., Jänicke, F., ... & Geist, S. (2016). Cyclin D1 gene amplification is highly homogeneous in breast cancer. Breast Cancer, 23(1), 111-119. Retrieved from https://link.springer.com/article/10.1007/s12282-014-0538-y/

Carey, L. A., Perou, C. M., Livasy, C. A., Dressler, L. G., Cowan, D., Conway, K., ... & Deming, S. L. (2006). Race, breast cancer subtypes, and survival in the Carolina Breast Cancer Study. Jama, 295(21), 2492-2502. doi:10.1001/jama.295.21.2492

Ghafoor, A., Jemal, A., Ward, E., Cokkinides, V., Smith, R., & Thun, M. (2003). Trends in breast cancer by race and ethnicity. CA: A Cancer Journal for Clinicians, 53(6), 342-355. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/16737949/

Hollstein, M., Alexandrov, L. B., Wild, C. P., Ardin, M., & Zavadil, J. (2017). Base changes in tumour DNA have the power to reveal the causes and evolution of cancer. Oncogene, 36(2), 158-167. doi:10.1038/onc.2016.192

Komen, S. (2017). Comparing Breast Cancer Screening Rates Among Different Groups | Susan G. Komen®. Ww5.komen.org. Retrieved from https://ww5.komen.org/BreastCancer/DisparitiesInBreastCancerScreening.html

Miller, K. D., Siegel, R. L., Lin, C. C., Mariotto, A. B., Kramer, J. L., Rowland, J. H., ... & Jemal, A. (2016). Cancer treatment and survivorship statistics, 2016. CA: A Cancer Journal for Clinicians, 66(4), 271-289. Retrieved from http://onlinelibrary.wiley.com/doi/10.3322/caac.21349/full

Smigal, C., Jemal, A., Ward, E., Cokkinides, V., Smith, R., Howe, H. L., & Thun, M. (2006). Trends in breast cancer by race and ethnicity: update 2006. CA: A Cancer Journal for Clinicians, 56(3), 168-183. Retrieved from http://onlinelibrary.wiley.com/doi/10.3322/canjclin.56.3.168/full