United States – Researchers have discovered that individuals who are African American and diagnosed with cancer in one breast are far less likely than white women to have the healthy breast removed, too.
Racial Disparities
Cancer in single-breast women is very common, which makes them remove the other breast for several reasons, according to researchers, as reported by HealthDay.
However, it seems that Black women are denied this window more often, mostly in hospitals that have a majority of white patients, recent research concludes.
In short, black women are as 35% percentage less than whites, which is known as contralateral prophylactic mastectomy (CPM), according to a study discovered.
Surprisingly, hospitals with a significant minority of Black patients also tend to have Black women 17% less likely than whites to get a CPM, based on the study results.
Structural Racism and Healthcare Systems
For instance, the sequence that these disparities existed in Black-serving hospitals implied “suggest these racial disparities to be encoded structurally,” said Dr. Amulya Vadlakonda, a third-year medical student at the David G. School of Medicine at UCLA
“We need to examine the systems-level factors affecting the care of Black women and address the deeper causes of structural racism to ultimately lead to equitable outcomes for all patients,” Vadlakonda added in a UCLA news release.
Addressing Disparities in Breast Cancer Treatment
In the United States, a one in eight chance of development of breast cancer exists for each woman. Among Black women, they have been reported to have a greater risk of breast cancer-related mortality when compared to white women, as described in the background.
A woman could do a CPM to avoid the possible issue of a cancer regeneration in the cancer-free breast or due to the expensive and stressful discomfort of attending mammograms for the remaining breast, researchers found out.
She can opt for CPM (breast reconstructive surgery) whether to match her cosmetic reasons or to enhance her appearance after the breast removal surgery, concluded the researchers.
“Nonetheless, it remains important to equitably engage patients of all races in shared decision-making,” Vadlakonda said. “Some women may feel that CPM is best for them, while others may wish for breast conservation as much as possible. Every patient should be able to make that decision for themselves when medically possible.”
According to Vadlakonda, opinions on the procedure’s long-term benefits are still divided.
Vadlakonda also noted: “However, the dedication to be equitable in terms of patient engagement from all races in shared decision-making should be upheld. What some women may feel is that breast-conserving mastectomy is the best choice for them and that some women may want to have breast conservation as possible. Every patient should be able to make that decision for themselves when it is medically possible.”
For their study, the researchers looked at information from the National Cancer Database from 2004 to 2020. The certificate contained almost 598,000 women, of whom roughly 12% were African American.
The study’s publication appeared in the Journal of the American College of Surgeons on April 11.
This bifurcation needs to be studied to find out whether it is because of doctors not recommending these procedures or Black women declining them, Vadlakonda explained.
Call for Standardization and Equity
“Our findings underscore that there is still a lot of work to be done to ensure equitable outcomes for patients of all races,” Vadlakonda said, as reported by HealthDay.
“The wide variation in the utilization of CPM across hospitals suggests that there is poor standardization in practice, which disproportionately affects Black patients,” Vadlakonda added. “We hope our findings will empower all patients to have open discussions with their doctors about the treatments that would be right for them.”