Race-Related Cancer Disparities Fall with Screening Mammography

Even though African-American women face a 40-percent higher rate of death from breast cancer than white women, partly due to an increased incidence of triple-negative breast cancer, screening mammography could help equalize outcomes between these two groups.

In new research, published online on Feb. 19 in JAMA Surgery, investigators from the Henry Ford Cancer Institute in Detroit discovered African-American women who were identified to have triple-negative breast cancer via routine screening experienced better survival rates. It’s possible, they said, that routine screening and early detection could eliminate race as a health disparity with triple-negative breast cancer.

“We report equal outcomes among equitably treated African-American patients and white American patients with triple-negative breast cancer,” wrote the research team, led by Henry Ford Cancer Institute’s Yalei Chen, Ph.D. “Screening mammography successfully detected early-stage triple-negative breast cancer, improving outcomes for both African American and white American patients.”

Overall, mammography is critical to early breast cancer detection, but triple-negative breast cancer has been historically difficult to identify through imaging. To determine whether regular screening could overcome this problem and, potentially, improve breast cancer results for African-American women, Chen’s team analyzed health data from 106 African-American women and 87 white women who had received a nonmetastatic triple-negative breast cancer diagnosis between January 2011 and December 2015.

During the study period, more African-American women were identified to have breast cancer than white women. Investigators reported the frequency of screening-detected disease was similar between both groups, 58.5 percent in African Americans and 44.8 percent in whites, respectively. Most identified tumors in both groups were invasive ductal tumors, and among the women whose triple-negative breast cancer cases were detected with mammography screening, the majority experienced T1 tumors and node-negative cancers. Additionally, those women were more likely to undergo a lumpectomy, 68.3 percent and 46.1 percent, respectively.

Among all factors considered and examined, the only factors that were significantly connected to survival rates were cancers with high-grade pathology and cancers pinpointed during screening. Ultimately, the researchers found, African-American women experienced a greater improvement in triple-negative breast cancer 4-year survival rates due to early detection during routine screening than did white patients.

Based on these findings, they wrote, screening mammography can play an integral role in limiting cancer-related disparities.

“Screening mammography is, therefore, an important strategy for reducing race/ethnicity-associated breast cancer disparities by optimizing overall survival for both population subsets,” they wrote.