What Black women need to
know about breast cancer
A leading expert shares four important tips for Black women
BY VIVIAN J. BEA, M.D
For Black women, breast
cancer is the most commonly
diagnosed cancer and the second
leading cause of cancer
death after lung cancer, according
the American Cancer Society.
While Black women and
white women get breast cancer
at about the same rate, Black
women are 40% more likely to
die from the disease, according
to a Centers for Disease Control
and Prevention study.
“This is a mind-opening
fact that shows disparities exist
within breast health,” says
Dr. Vivian Bea, section chief
of breast surgical oncology at
NewYork-Presbyterian Brooklyn
Methodist Hospital and an
assistant professor of surgery
at Weill Cornell Medicine.
“But we can’t pin it to exactly
one thing.”
Dr. Bea, who is committed
to eliminating disparities
through research and health
initiatives, says many factors
contribute to breast cancer
disparities, ranging from social
determinants to genetics
and tumor biology. She spoke
to us about what Black women
should know about their breast
cancer risk and breast health,
and dispels myths about a
breast cancer diagnosis.
1. Know the facts
Researchers are working to
better understand why there’s
such a big disparity in breast
cancer outcomes between
Black and white women. Access
to care is an issue, but
other factors include genetics
and tumor biology, says
Dr. Bea. “We used to believe
breast disparities were primarily
due to lack of access to
healthcare, and then policies
were implemented that actually
improved mammography
screening and insurance
availability, and yet the disparity
still exists,” she says.
Research indicates that genetics
may play a part in this
higher risk disparity, and the
risk may differ depending on
a Black woman’s ancestry,
specifi cally in cases of triplenegative
breast cancer. Black
women are more likely to have
COURIER L 16 IFE, OCT. 9-15, 2020
triple-negative breast cancer,
a rarer but more aggressive
form that does not respond to
hormonal treatment. According
to the American
Cancer Society,
triple-negative breast
cancer is about twice
as common in Black
women than white
women in the U.S., and
a contributor to the lower
breast cancer survival
rate among Black
patients. “It’s important
that Black
women know their
risk for breast cancer,
so that they can
educate themselves
and be proactive
about their health,”
says Dr. Bea.
2. Get screened — and
bring a friend
Early detection is the best
protection. “Even though
Black women are more likely
to have triple-negative breast
cancer, if we catch these
women at the earliest stage of
that breast cancer, there is a
better chance for survival,”
says Dr. Bea.
The American Cancer Society
says women should have
the choice to start screening
with yearly mammograms
as early as age 40 if they want
to, and recommends women
should begin having yearly
mammograms by age 45, which
can change to every other year
beginning at age 55. If you have
a family history, you should
start screenings earlier. “Black
women are more likely to be diagnosed
at a younger age with
the more aggressive tumor
subtype, so I recommend going
annually starting at the age of
40,” says Dr. Bea.
If you’re nervous about
getting a mammogram, Dr.
Bea recommends going with
a friend so you can hold each
other accountable and have
moral support. “I understand
that it is not a piece of cake for
everyone and can be nervewracking,”
she says. “Maybe
do a spa day or a girls’ day after
to ease the stress and anxiety
around the appointment. Take
the focus off the mammogram
and make it a whole ritual.”
Through a multi-institutional
grant she received from
the American Cancer Society
and Pfi zer, Dr. Bea is focusing
on improving access to screening
mammography for Black
women in the Brooklyn community
by extending hours at
NewYork-Presbyterian Brooklyn
Methodist Hospital a few
times a month and providing
access to breast imaging.
“We are also working
with navigators within faithbased
organizations to help
get the word out and encourage
women in their church
to receive their annual mammogram,
even in the era of
COVID-19,” she says.
3. Don’t believe myths
There is understandably a lot
of fear around a breast cancer
diagnosis, but it is important to
be aware of the many advances
made in care. For example, Dr.
Bea says some patients have expressed
concern that if they receive
a diagnosis of cancer and
have surgery, the surgery could
cause the cancer to spread.
“This is false,” she says.
Women may believe that
surgeons will have to remove
their breasts, which is also not
true. “We can offer modern approaches
to breast surgery,
such as lumpectomy or breastconserving
surgery, which
only removes a portion of the
breast,” says Dr. Bea. “Those
myths, coupled with a valid fear
of COVID, may be widening the
gap of women not getting their
mammograms right now. But
it’s important to remember
early detection saves lives.”
She emphasizes that women
should not let a fear of COVID
stop them from getting their
mammograms. “COVID is real,
but women should know it is
safe to come into the hospital
to get their mammogram,” she
says. “It is a risk-benefi t situation.
Wear a mask, practice social
distancing, and use hand
sanitizer to balance off that risk
and get your mammogram.”
4. Know your breasts
Dr. Bea encourages women
to do a breast self-exam every
month. “If there is an abnormality,
you’d be the fi rst to detect
it,” she says. Signs to look
for include nipple discharge, a
palpable mass (a lump), or any
skin changes. “If you’ve never
had eczema, a condition that
makes your skin red and itchy,
in your life, and you see skin
changes on your breast, do not
assume it’s eczema. Go and see
your provider,” she advises.
Clinical breast exams are
important at least yearly with
a licensed practitioner.
Dr. Bea hopes that by building
trust with her patients and
prioritizing education, outreach,
and early diagnosis, she
can address disparities in the
community and save lives. “I
have a voice and it’s my duty to
use it and be at the forefront of
this conversation.” She says she
is active on social media to try
to reach even more patients.
Equally important is a
diverse care team. “NewYork
Presbyterian Brooklyn
Methodist Hospital has a multidisciplinary
team of Black
women who treat breast cancer,
which is rare,” says Dr. Bea. “If
you are diagnosed with breast
cancer, it’s important to receive
high-quality care, which we offer
here with a diverse multidisciplinary
department.”
“I love my position because
I know that every day I am
making a difference, even if
it’s touching just one life,” says
Dr. Bea. “When someone who
looks like me hears me explain
breast cancer risks and relate
to them, understanding from a
cultural standpoint where they
are coming from, we’re able
to connect and they are more
likely to listen to me and trust
me. And that trust can make
the difference in a life or death
situation.”
Vivian J. Bea, M.D., is section
chief of breast surgical
oncology at NewYork-Presbyterian
Brooklyn Methodist Hospital
and an assistant professor
of surgery at Weill Cornell
Medicine. An expert in breast
cancer disparities, Dr. Bea was
selected as one of the 40 Under
40 Leaders in Minority Health
by the National Minority Quality
Forum for her dedication
to community outreach and
breast cancer disparities research.
She is on Twitter at @
IamDrVivian.
To make an appointment
with Dr. Bea, please call 718-
780-3022.
Dr. Vivian J. Bea, M.D. New York-Presbyterian Brooklyn Methodist Hospital