If we are restating information for an article, we don’t need to add the numbers. We can just hyperlink and reference once per source. ‍

October is a transitional month. This season heralds reflection, determination, joy, and sorrow. Additionally, October is a month when we remember the bravery of our loved ones who have battled breast cancer. 

 After almost 40 years, NBCAM is now a well-known call to action in October from the community, business, and research groups that launched in 1985 with the goal of "raising awareness of breast cancer, spreading information about the disease, and making it easier for people to get services" (2).

One in every eight women in the United States will be diagnosed with breast cancer (2, 3, 4, etc.). Despite a decrease in cancer deaths overall, approximately 41,000 people die yearly from metastatic breast cancer. That number hasn’t shifted since the 1980s (1). If cancer reaches the regional lymph nodes or distant body parts, the 5-year survival rate drops to 86% and 29%, respectively (2).

However, jarring inequities are present in the US cancer care system. 

The below graph from the American Cancer Society shows that breast cancer in the US doesn't always care about race or ethnicity. Yet, the death rate for Black women was much higher compared to that of white women between 2015 and 2019. The Breast Cancer Statistics 2022 study confirms that this trend has worsened. 

In 2022, the number of breast cancer diagnoses will be similar among BIPOC and white women. However, the death rate for specifically Black women is about 40% higher than that of white women (11).

Read that again. Black women with breast cancer are 40% more likely to die than white women. 

At this point, we know cancer isn’t an outlier. It’s the healthcare system.

Black patients receive less than optimal healthcare compared to white patients for several reasons.

One is doctor bias.

 The quality of appointments and conversations between patients and doctors is affected by these pre-set biases based on race.

Several studies have found that when a patient and doctor are of the same race, the appointments last longer than when they are not.Researchers found that non-black doctors with higher levels of predetermined racial bias used more first-person plural pronouns (like "we" and "us"), words about anxiety, and complicated medical jargon during visits. 

Additionally, Black patients with white doctors less accurately remembered what happened during their appointments. Patients said they didn't feel included in decision-making and were less likely to follow treatment plans. BIPOC breast cancer patients reported receiving little information about potential treatment side effects, such as infertility.

Misconceptions about how Black women emotionally handle their diagnoses and treatment(s) manifest in inadequate levels of support and counseling are another example of how doctor bias and the perception and understanding of their patients endangers the lives of Black patients.

Due to how serious these operations and medicines are, the relationship between a patient and doctor can affect the patient's treatment and recovery. Having a strong and trustworthy relationship with a doctor at such a vulnerable time can mean the difference between life and death.

Two, lack of resources and options.

Black women are less likely than white women to have good health insurance but more likely to battle heart disease, diabetes, and other chronic illnesses. All of this, plus getting from primary care facilities to oncology departments, can be hard to understand, take a long time, cause a lot of stress, and cost a lot of money. 

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Lack of trust and community makes black patients less likely to follow up with their doctors after treatment, which is important for lowering the chance of breast cancer returning. It’s no wonder that BIPOC women are more likely to be diagnosed with breast cancer at an earlier age and in a more advanced state.

3. Healthcare with Doctors of similar intersections 

Within our healthcare system, there is a serious underrepresentation problem, only 5% of US active doctors are Black, and only 2% of Black female doctors  as well. 

The ramifications of a lack of diversity in our doctors extend beyond racism and higher Black mortality rates. 

Ultimately, seeing a doctor is a very vulnerable thing to do. In the case of breast cancer, women’s lives are in doctors’ hands, and for those hands to not be receptive, or even accepting, of the backgrounds and experiences of Black women is jarring. It causes a vicious cycle of distrust and misinformation between healthcare providers and the Black community, especially when there are  Black voices advocating for change that are not at the top of our healthcare structure.

5% of active physicians in the US are Black, and 2% are Black and female (21). Black providers can offer Black patients a safe, culturally competent, and communal environment that white providers usually cannot .

What does Equity Look Like Here?

One of the first avenues leading to improved healthcare quality for Black women is hiring more Black female doctors. Educational outreach programs such as "Black Girls Do STEM" provide opportunities to delve into science and technology at a young age. They are affording more girls of color the resources to pursue careers in science and medicine through after-school programs, scholarships, intensives, and mentorship. 

Black providers can offer Black patients a safe, culturally competent, and communal environment that white providers usually cannot (19). Understanding patient values positively influences the decisions they make together, making the healthcare system a more trustworthy place. (link to BGDS Instagram)

All underrepresented people need easy-to-access, high-quality cancer screening and treatment options to find tumors earlier, and many FEMTECH companies are up for the challenge. Health, ease, accessibility, and comfort are brought to the mammogram experience. They have created an AI-driven ultrasound breast imager that is 10–15 times faster than traditional manual probing. Each breast scan takes 2 minutes, does not require an ultrasound technician, and is painless. The fact that it is portable and allows for more available and frequent breast cancer screenings is incredible, not to mention what an invaluable resource it will be for future cancer research.

The team at Clairity approaches breast cancer from a preventative standpoint, using AI and mammogram technology to identify women at high risk of developing breast cancer. With this technology, doctors can work with their patients even more to lower their risk of breast cancer. Clairity has also acknowledged that past risk models for breast cancer were dominantly based on white women and is altering system standards to fully benefit the full diversity of patients who experience breast cancer.

Keep a Breast is a thriving online community whose goal is to reduce the risk of breast cancer through education, prevention, action, and art. They have comprehensive lists of resources and outreach opportunities for the Black and LGBTQA+ communities, and they’ve also created a free app that walks you through monthly breast checks. We downloaded it and found it to be encouraging, body-positive, and comprehensive. The app also makes contacting a physician easy if you find any abnormalities during the check. (link to their Instagram)

The final solution we would like to offer is one for current medical professionals. It is a reminder to educate yourself and lead with empathy. Every patient is entitled to annual, high-quality care as well as active participation in discussions about diagnosis and treatment. Understanding that this is absolutely not the case in the US is the first step to practicing cultural humility.

Every patient is entitled to annual, high-quality care as well as active participation in discussions about diagnosis and treatment.

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We watch the markets for the continued effects of the pandemic as we approach the end of 2022, where masking policies may have relaxed and social distance is more of a suggestion than a requirement. The pandemic has the potential to continue claiming more lives. 

With delays in cancer screening, diagnosis, and treatment due to the pandemic, breast cancer will cause 10,000 extra deaths from breast and colorectal cancer in the next ten years .

With low screening rates, specifically in the Black female community, and the difficulty of accessing quality healthcare, women across the board, especially Black women, require access, solutions, and a healthcare system that prioritizes them. 

Our goal is to cultivate a more empathetic healthcare experience that places value on patients’ needs while maintaining the standards of medical care. As we near the end of Breast Cancer Awareness Month, we invite you to think about how to enact change so everyone can feel supported in a doctor’s office.

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