Health
Breast Cancer Screening at 42? Black women should, according to research.
Increasingly, Dr. Ryland Gore is diagnosing black women with breast cancer at a young age.
Black women are more likely to be diagnosed with aggressive and fast-growing breast cancer subtypes. said the cancer had progressed.
She worries about her patients and hopes that national guidelines will encourage high-risk patients, like black women, to be tested at a younger age.
“When these women are in their 30s, 30s, 33s, 34s and they consistently come over and over and over and over again, it’s no longer a one-off. I have to do something,” she said.
Recent study An assessment of breast cancer mortality in 415,000 U.S. women suggests that black women should be screened at age 42, compared with the recommended age of 50 for the general female population.
Researchers calculated that 27 per 100,000 black women died in their 40s. This far exceeds the rate of white women who die in their 40s at 15 per 100,000 of her population.
“Current one-size-fits-all policies that screen entire populations of women of a given age may not be fair, unbiased, or optimal,” wrote the authors of an analysis published in JAMA Network Open. .
The study has caused controversy among health equity advocates. While many say they are starting the early screening debate, some experts and survivors say black women should be screened even earlier, under the age of 40. , hopes that a unified approach will be developed and the official guidelines will be updated.
“It’s time to have another discussion,” Gore said. “Why wait until the eleventh hour when you can completely change the course of that woman’s life, knowing that certain groups are at risk?”
Currently, there is no national consensus on breast cancer screening under age 50, and recommended ages vary by group.
The U.S. Preventive Services Task Force (usually an independent panel of experts who set national recommendations) is reviewing current guidelines, last updated in 2016. Women aged 50 to 74 in these states are screened for breast cancer every other year. Those in their 40s with concerns should make an individual decision with their clinician.
“Too many women face the challenge of coping with breast cancer each year. We all want better screenings, better treatments and better ways to prevent this devastating disease. I am particularly interested in understanding what research shows about how best to address this disparity.”
On the other hand, the American College of Radiology suggests that all women undergo annual screening starting at age 40, with high-risk groups such as black women undergoing a risk assessment by age 30.
Similarly, the American Cancer Society says women should start screening at age 45, but should give women the option to start screening at age 40.
A unified approach is needed, said Dr. Vivian Bee, chief of breast surgical oncology at New York-Presbyterian Brooklyn Methodist Hospital and breast surgeon at Weill Cornell Medicine.
“It’s confusing for doctors and health care providers who are counseling patients,” she said. “It’s also confusing for patients.”
She added that essential primary care doctors have told her they are having trouble getting insurance companies to approve mammograms or ultrasounds for young black patients because many patients do not have access to specialists. .
They “often have to fight with insurance companies to get screening mammograms for their patients,” she said. …because of guidelines set and determined, they cannot do what might be right.”
more:Breast cancer tumor data do not include black women.and it might be killing them
Studies have shown that black breast cancer patients are more likely to be diagnosed before age 40 than white patients.according to the latest analysis For example, among all racial groups, black women accounted for the highest number of cases among patients diagnosed under the age of 40, according to the American Cancer Society. analysisBack in 2002, more than 10% of black women with breast cancer were diagnosed with breast cancer before age 40, compared with 5% of white women.
“Being an advocate for patients who are disproportionately affected by the current recommendations by the US Task Force and actually speaking up should really light the fire under all of us,” Bear said. Told.
Robert Smith, a cancer epidemiologist and senior vice president for early cancer detection at the American Cancer Society, has reviewed the guidelines since 2015.
“We consider the issue that different recommended ages may be appropriate for different subgroups of the population,” he said. It is included.
Karen Jackson, who has had breast cancer four times, said she wished she had had an earlier check-up. She was 48 when she was first diagnosed. Initially, her mammogram found no tumor, but Jackson, knowing her family history, requested an ultrasound of her, which picked up her mass.
Her doctor said the slow-growing 3.5-centimeter lump had been there for several years, possibly six years or more.
“I was living with something I couldn’t feel with my hands,” she said. “Ultrasound saved my life.”
Just months after being diagnosed 30 years ago, Jackson started The Sisters Network, a black survivorship group. Reflecting on her judging criteria, she remembered her deceased member.
“I’m talking about women who used to live but are dead now. The guidelines didn’t work for them,” she said. “We got to know early on that we were going to die before we turned 40.”
Bea praised the study for “highlighting what we really need to do better: come up with better recommendations based on age, race and ethnicity.” He said that
However, “forty-two is definitely not enough.”
Reaching Nada Hasanein [email protected] or on twitter @nhassanein_.
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