Earlier this week, many of us were surprised to learn that Angelina Jolie made the brave choice to have a double mastectomy and then chose to share her story with the entire world via The New York Times. Her announcement ignited a flurry of conversations that have crossed racial and gender lines. Social media network communities were engaged in a dialogue and people were sharing experiences, knowledge, and words of support. The buzz helped many realize that it is a big deal for a 37 year old, high profile celebrity disclose why she made the difficult choice of removing not only one but two of her breasts. This exchange is important for all, but especially for the African-American community.
African-American women are two times more likely to die from breast cancer even though we are diagnosed less than White women. African-American women are also more likely to get aggressive, fast growing, hard-to-treat breast cancers known as triple-negative cancers. This is different than the BRCA-related cancer that Jolie sought to avoid. However, despite the more aggressive cancers seen in African-American women, recent studies have shown that for all types of breast cancer, aggressive or not, survival rates among African-American women are lower.
Despite the fact that African-American women get mammograms at the same rate as White ones, there are some critical factors that likely contribute to the disparity in survival rates:
- Delayed follow-care and treatment initiation after diagnosis by the patient
- Less standard quality of care provided by health professionals
- Poverty and its impact on healthcare in some communities
One factor that undermines our progress in health is our history of silence, which is usually fed by fear, uncertainty, and sense of fatalism (“I’m going to die from something anyway.”) An added layer is our fear of losing our sensuality, sexuality, and femininity.
The silence is killing us. It prevents us from learning information and hearing experiences about the disease from medical experts and from each other. There are most likely women who have recently felt a lump, noticed a change in their breast, or have a known family history of breast cancer who quickly changed the channel or have avoided the conversations on Facebook and Twitter in order to not deal with their own current circumstance.
So what are the symptoms of breast cancer? Most women do not have any symptoms early on. This is why screening with a mammogram is important. If there is a sign present, the most common one is a new lump or mass that is typically painless and hard with irregular edges. For advanced disease, symptoms may include:
- Swelling of the breast
- Skin irritation or dimples
- Pain in the breast or nipples
- Thickening of the nipple or breast
- Discharge other than breast milk
Risk factors for breast cancer include being a woman, having a family history, older age (African-American women also have an increased risk at less than 45), the presence of certain genes such as BRCA, a previous history of breast cancer, being overweight (fat cells produce estrogen which is linked to stimulating the growth of certain breast cancer cells), and having no children or children after 30.
Early detection is crucial. The American Cancer Society recommends starting mammograms at age 40 unless you have risk factors or detect changes in your breasts, you may need one earlier. Go for yearly check-ups starting in your 20s and learn your breasts' shape and feel so that you can recognize change if it happens.
Eating fruits and vegetables, especially raw, exercising on most days of the week for 30 minutes, maintaining a healthy weight, and consuming good fats such as olive oils and fish oils with Omega-3 helps to decrease your risk of breast and other cancers.
The reality is that your health is not only about you but also about your family and friends that surround you. We are all affected in health, and many times we are each other’s best resources. Therefore, it is vital that we tune-in, and stay tuned; connect and stay connected; share and keep sharing.
Dr. Aletha Maybank is a board certified physician in both Pediatrics and Preventive Medicine/Public Health. You can follow her on Twitter: @DrAlethaMaybank