by: alexia achu, catherine phamduy, & yen phan€¦ · susan g. komen. 22, jan. 2015. •...
TRANSCRIPT
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By: Alexia Achu, Catherine Phamduy, & Yen Phan
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Female Breast Composition
Lobules: milk producing glands Ducts: ducts that carry the milk
from the lobules to the nipple Stroma: fatty tissue and connective tissue surrounding the ducts, lobules, blood vessels, and lymphatic vessels.
2 NIH: National Cancer Institute
Female Breast Anatomy
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Important Definitions Cancer: uncontrolled abnormal cell growth
Breast cancer: arises from abnormal cell growth in the breast
tissue
3 MRI of a healthy breast (left) versus MRI of a breast
containing a tumor (right)
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Genetic and Hormonal Factors
Specific inherited mutations in BRCA1 & BRCA2
o genes that normally work to prevent cancer from developing
Hormone testing
o hormone (estrogen and progesterone) receptors and HER2/neu receptors
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What are Health Disparities?
Health Disparities:
preventable differences in the incidence, prevalence, mortality and burden of diseases and other adverse health conditions that exist among specific population in the United States
-N.I.H
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Why is Breast Cancer Mortality a Health Disparity?
African American women have a higher breast cancer mortality rate than the general population in the state of Massachusetts.
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Breast Cancer Mortality Statistics in Massachusetts
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Year 2011
Kff.org/state-category/womens-health/?state=MA
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Contributing Factors to Breast Cancer Disparity
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Socioeconomic -Lack of Transportation -Lack of Education -Poor Health Insurance -Cultural Barrier -Income
Access to Health Care -Delay of diagnosis -Delivery of healthcare -Treatment delay -Lack of follow-up
Lifestyle -Overweight & Obese -Unhealthy Diet
Genetic -Triple Negative Breast Cancer
Breast Cancer Disparity
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Socioeconomic Status-Poverty Rate
9 http://www.umb.edu/editor_uploads/images/centers_institutes/center_social_policy/Poverty_in_Massachusetts_by_Race.pdf
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Socioeconomic Status –Quality of Health Insurance
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Medicaid Coverage Rates for the Nonelderly by Race/Ethnicity in 2013
http://kff.org/medicaid/state-indicator/rate-by-raceethnicity-3/?state=MA
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Quality of Health Care in Massachusetts
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Year 2013 Kff.org/state-category/womens-health/?state=MA
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Access to Health Care - Treatment
Delay in diagnosis
Treatment delay
Lack of follow-up Poor treatment
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Lifestyle
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Race State 3-Year %
White Non-Hispanic
21.7 (21.1- 22.4)
Black Non-Hispanic
30.6 (27.5- 33.6)
Hispanic 29.1 (26.3 - 31.8)
Asian Pacific Islander
8.1 (5.3 - 10.9)
Obese Based on Body Mass Index by Race in Massachusetts
http://www.mass.gov/eohhs/researcher/community-health/masschip/health-
risk-factors-racehispanic-ethnicity-report.html
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Genetic Factors
Triple-negative-hormone/Hormone-negative tumors – Triple Negative Breast Cancer: poorer prognosis
due to a lack of a targeted treatment for triple negative cancers in comparison to other breast cancers.
14 http://economictimes.indiatimes.com/news/science/scientists-identify-gene-behind-triple-negative-breast-cancer
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Undoing the Disparity- New Methods
A new method that predicts breast cancer risk specifically for African American women
Using this model expands the
care for African American women at relative risk rather than absolute risk.
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Undoing the Disparity
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Summary
Mortality rate of breast cancer in MA is higher in African American women
Contributing factors
Hopes for change
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Questions?
18 http://health.clevelandclinic.org/2014/02/14-questions-about-your-breast-cancer-diagnosis/
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References • Albelda, R., Carre, F., Cheah ,E., and Marcellot L. Poverty on Massachusetts by Race, ACS 2008-2012
estimates. Center for Social Policy. 2014.
• Are there different kinds of breast cancer? Centers for Disease Control and Prevention. 21, Jul. 2014.
• Breast Cancer. American Cancer Society. Feb. 2014.
• Cancer Health Disparities. National Cancer Institute. 11, Mar. 2008.
• Disparities in Breast Cancer Screening. Susan G. Komen. 22, Jan. 2015.
• Disparities in Breast Cancer: Through the Breast Cancer-Care Continuum. Breast Cancer Action. Nov. 2013
• Levy, D.E. Underutilization of BRCA1/2 testing to guide breast cancer treatment: Black and Hispanic women
particularly at risk. Genetics in Medicine. 2011 13
• Massachusetts comprehensive cancer prevention and control plan: 2012-2016. Massachusetts Department of
Public Health.
• McCormick, Cynthia. Cape breast cancer statistics called ‘scary.’ Cape Cod Times. 10, Jan. 2012.
• O'Keefe EB, Meltzer JP and Bethea TN (2015) Health disparities and cancer: racial disparities in cancer mortality
in the United States, 2000-2010. Front. Public Health 3:51.
• Pande, A et al. Effects of Healthcare Reforms on Coverage, Access, and Disparities: Quasi-Experimental Analysis
of Evidence from Massachusetts. American Journal of Preventive Medicine. Jul 2011. 14:1
• Parise and Caggiano: Disparities in race/ethnicity and socioeconomic status: risk of mortality of breast cancer in
the California Cancer Registry, 2000-2010. BMC Cancer 2013 13:449.
• Tian et al.:Spatial association of racial/ethnic disparities between late-stage diagnosis and mortality for female
breast cancer: where to intervene? International Journal of Health Geographics 2011 10:24
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