Twelve years ago, Maiya Hayes found a suspicious mass in her chest during a self-exam. She quickly made an appointment with her gynecologist to help plan the tests that turned out to be stage 3 breast cancer.
Her oncologist told her that the aggressive nature of her breast cancer, which had spread to the lymph nodes under her right armpit, meant a 60% chance of it coming back. The diagnosis came as a shock to Hayes, who had just turned 30 earlier this year.
“At first I was very naive about the whole thing – probably because I had an attitude that I was immortal when I was younger,” said Hayes. “I was scared and devastated and honestly thought I would never see my 40th birthday.”
As a black woman, Hayes was more likely to develop breast cancer under the age of 45 than women of other races or ethnic groups. And while breast cancer is the most common cancer in women of all races in the United States, along with skin cancer, black women under 50 are 40% more likely to die from it than white women, and twice as likely to die over 50.
The higher death rate is even more worrying when you consider that black women between the ages of 60 and 84 are less likely to develop breast cancer than white women.
“This difference is unacceptable and we are working to find out,” said Dr. William Cance, surgical oncologist and senior medical and research fellow for the American Cancer Society. “It’s complicated – clearly differences like access to quality care and treatment play a role, but there are also biological differences that we don’t fully understand.”
For example, black women are also more likely to be diagnosed with invasive cancer or triple negative breast cancer, which are more difficult to treat and reduce the likelihood of longer-term survival.
Eliminate the differences
Helaine Bader, HealthyWomen’s Senior Advisor on Health Education, said that black women are often diagnosed later than white women, resulting in delayed treatment. Early detection and treatment make a significant difference in survival outcomes, especially with the invasive forms of breast cancer. Black women are at higher risk of developing.
Even after diagnosis, delays in care were more common in black women than in white women. A recent study found that black women delayed starting their treatment by two months or more after diagnosis and had longer periods of care. Race was more closely linked to this delay than socioeconomic status.
“We know that many underserved communities experience these differences in care, and breast cancer is no exception,” Bader said.
Cance mentioned a scenario he encountered frequently in his public relations efforts: women were given a mammogram but had the results sent direct to their homes without instructions to see a doctor. Lack of funding for treatment, limited access to health facilities, and even fear could prevent women from seeking treatment after screening, and the COVID-19 pandemic has only exacerbated these challenges.
Searching for help
There are steps black women can take to reduce their risk of breast cancer or improve their chances of survival once diagnosed. Self-examinations, mammograms over 40 years of age, and prompt treatment after diagnosis are a must. Younger women outside of the typical screening age should consider their family history of breast cancer to determine if they belong to a risk group. Cance suggests speaking to a doctor about genetic testing and discussing the potential need for early screening and drug regimens to reduce risk.
Research is being done to determine cancer risk through blood tests, which may help reduce biological differences between races and ethnic groups.
Eating well, exercising, and losing weight also help reduce breast cancer risk and improve treatment outcomes. Research shows that women who are overweight, despite receiving timely treatment, have a decreased survival rate from breast cancer and may have more complications related to their treatment.
A second chance
Hayes had many factors in her favor when she started her treatment, including early diagnosis and good health insurance from her employer. Her treatment consisted of a lumpectomy in her right breast, an axillary dissection of the lymph nodes in her right armpit, 16 rounds of chemotherapy, 35 rounds of radiation, and one year of infusions of a drug to inhibit cancer cell development. She also took a drug to block estrogen receptors – since naturally occurring estrogen can increase the growth of breast cancer cells – for 10 years.
Hayes said she knew she would lose her hair and feel sick, but she was shocked at how debilitating her nausea, vomiting, and fatigue became.
“In the deepest moments of my chemotherapy, I felt so bad that I cried to God – and at that point I wasn’t a very spiritual person,” she said.
In the years following her treatment, Hayes has worked to keep her immune system healthy through good food and exercise, and she maintains her sanity through psychotherapy. She never misses a routine checkup or screening and see a doctor quickly when sick. She’s also taking extra precautions by limiting interactions outside of her home during the pandemic.
During her trip, Hayes became a member of Gildas Club Metro Detroit, a local branch of the national support group for cancer survivors, their friends and families. She made new friends and mourned others, including women in her age group who died of breast cancer.
“After I finished my chemo and radiation treatments, I realized that my life would never go back to what it was before cancer,” said Hayes, who turned 42 in April. “I’ve decided to stop worrying about little things and get more open-minded. I realized how fragile life is and how happy I am to be alive.”
American Cancer Society