Melissa Joyner
UTMB Galveston, USA
Title: Barriers to breast cancer care: Cultural and socioeconomic challenges in the 21st century
Biography
Biography: Melissa Joyner
Abstract
One of the greatest challenges that we currently face in overcoming breast cancer is not related to technology or available
drug regimens to treat breast cancer but rather to barriers to obtaining the care itself based on different ethnic and
cultural issues. Billions of dollars have and will continue to be spent in an effort to cure breast cancer. But women from varying
ethnicities face genetic, cultural, socioeconomic barriers, dietary standards, lack of awareness, and access to care which appear
to represent the greatest hurdles to treatment.
Based on research data, genetics clearly plays a significant role in breast cancer. The National Cancer Institute data shows
that white, non-Hispanic women are most likely to be diagnosed with breast cancer but black women of African descent tend
to develop cancer at a younger age, have more aggressive tumor characteristics (3x more likely to have triple negative disease),
and have decreased survival rates with advanced cancer based on retrospective data. Hispanic females in the U.S. with a
family history have double the risk for triple negative disease and they present with cancer at a younger age. The amount of
estrogen levels also appears to vary by race in analysis of data on postmenopausal females. Many studies have shown that
African American ancestry are less likely to get breast cancer, they have an almost 40% risk of dying from their disease versus
a Caucasian female and their risk is higher than any other ethnic group. Asian American women is the United States have a
lower risk of breast cancer but are more likely to present with advanced disease largely in part felt to be associated with fact that
they obtain mammograms less often. Likewise, only 1/3 of Hispanic females age 40 and older obtain regular mammograms.
Furthermore, Hispanic females will often wait to seek care even when they have self-palpated a mass, resulting in not only a
delay in diagnosis but also resulting in more advanced disease at presentation.