Overall survival of breast cancer has improved for everyone in the U.S. in recent years, but the pace isn’t the same for all groups of people. Some groups still experience dramatic disparities.
For example, according to the American Cancer Society:
- Black women are the most likely of all racial groups to be diagnosed with breast cancer at a later (more advanced) stage, when the cancer is harder to treat.
- Black women have a 40% higher risk of dying from breast cancer than white women.
- Breast cancer is the leading cause of death for non-Hispanic Black and Hispanic/Latina women.
- Screening rates are lowest among uninsured people, recent immigrants, and individuals without a high school education.
- Screening rates are also lower among LGBTQ+ people, who report high rates of discrimination in medical encounters.
Dana-Farber wants to close these gaps so that everyone benefits equally from high-quality care and leading-edge treatment. Its breast oncology team has many programs and initiatives that aim to address root causes of disparities in breast cancer screening, access to care, and breast cancer diagnosis.
“We are looking at every possible avenue to address disparities,” says breast oncologist Erica Mayer, MD, MPH, director of clinical research in the Breast Oncology Program. “We welcome everyone and want to take care of everybody.”
Access to breast cancer screening
Screening is important because it can help identify breast cancer earlier when it is easier to treat. Dana-Farber’s Mammography Van provides mammograms and breast health education in the Boston area for people who might not have easy access to screening. Preregistration is required. Check their upcoming calendar and contact the mammography van office at 617-632-1974 or via email to make an appointment.
Free screening programs are also available across the country.
Learn more about breast cancer screening guidelines.
Breast cancer patient navigators
Facing a cancer diagnosis can be overwhelming. Navigating the health care system, managing appointments, and working out insurance and payment can be as well.
The Dana-Farber Breast Oncology Program has a dedicated patient navigator to help lower these and other barriers patients face when trying to access breast cancer care. Patient navigators, supported by Dana-Farber’s Cancer Care Equity Program, are focused on helping patients based on their zip code, race, and/or language. Services include:
- Reaching out and learning specifically about a patient’s needs.
- Arranging transportation.
- Providing appointment reminders.
- Attending appointments to provide support.
- Arranging translators.
- Connecting patients to social workers and resources that can help with food insecurity and housing.
“Patient navigators are devoted to reaching a population of patients who are most likely to benefit,” says Dana-Farber breast oncologist Rachel Freedman, MD, MPH. “They are doing amazing work.”
Reducing disparities in the diagnosis of inflammatory breast cancer
Inflammatory breast cancer is rare, representing just 2 to 3 percent of all breast cancer cases. But it is an aggressive disease that can be cured if it is found before it has spread.
The challenge is that the disease, which appears as redness or thickening of the breast skin, is frequently missed or misdiagnosed, particularly in patients with darker skin. People of color are at a higher risk of developing the disease, so it is important to know the signs:
- Darkening of the skin of the breast
- An orange-peel appearance or thickening of the skin
- Swelling or inflammation that becomes painful
To reduce misdiagnoses, Dana-Farber’s Filipa Lynce, MD, director of the Inflammatory Breast Center, has been working with a team of collaborators to develop a clinical support tool available for primary care doctors and community physicians. The tool helps the physician assess symptoms and provides a score indicating the likelihood of inflammatory breast cancer. If the likelihood is high, the doctor can refer the patient for follow-up with an oncologist.
Because inflammatory breast cancer is aggressive, immediate treatment is necessary. Patients with barriers to care, including difficulties with transportation, childcare, scheduling, or insurance, might need extra help.
At Dana-Farber, patient navigators and care teams can help.
“We know how aggressive this disease can be,” says Ryan Tamargo, NP, a nurse practitioner in the Inflammatory Breast Cancer Program. “We want to get our patients in for treatment no matter what it takes.”
Learn more about breast cancer from Dana-Farber Cancer Institute.
About the Medical Reviewer
Dr. Mayer received her medical degree from Harvard Medical School, completed her residency in Internal Medicine at Brigham and Women's Hospital, and her fellowship in Medical Oncology at the Dana-Farber Cancer Institute. She also obtained a Masters in Public Health from the Harvard School of Public Health. She joined the staff of Dana-Farber and Brigham and Women's Hospital in 2006, where she serves as Director of Breast Cancer Clinical Research. She is a breast cancer medical oncologist and clinical investigator leading research studies focused on novel therapies for the treatment of breast cancer.