Breast cancer mortality is down but cases are up. North Texas health experts weigh in
KERA | By Kailey Broussard
Published October 7, 2024 at 5:00 AM CDT
For North Texas health care professionals and advocates, new breast cancer statistics from the American Cancer Society provide both hope and a reminder of the work needed to improve early detection and access to screenings.
Mortality rates for breast cancer have fallen by 44% since 1989, according to the study – a sign that improved technology has contributed to greater detection. However, breast cancer incidence rates increased by 1% each year between 2012 and 2021. Asian American and Pacific Islander women, as well as women under 50 years old, represented sharper increases.
Dr. Heather McArthur, clinical director of the breast cancer program at Harold C. Simmons Comprehensive Cancer Center at UT Southwestern, said she believes the overall increase in breast cancer incidence rates reflects improvements in screening techniques and education. She said health care officials are trying to understand the reasons behind the uptick in younger patients.
“It’s likely a function of environmental factors, and so there’s more work to be done in terms of improving screening in young participants,” she said.
Cancer incidence rates in AAPI women rose 2.6% annually between 2012 and 2021. The report cites a rise in Asian immigrants, who may have higher breast cancer risk than Asian women born in the U.S., as a possible factor.
Frances Leung, director of the Asian Breast Health Outreach Project in Richardson, described the report as a “wake-up call” for Asian women to take care of their breast health.
“Acculturation, change in diet, delay of childbirth after 35, use of hormone replacement, et cetera, after they have moved to the U.S. may all contribute to an increase in risk for Asian women to have breast cancer,” Leung wrote in an email. “Unfortunately, compared to other ethnic groups, Asian women have a lower screening rate, especially for those who have no insurance and low income.”
Over the past 20 years, Asian American and Pacific Islander patients went from being the fourth most-likely group under 50 years old to develop breast cancer to equal likelihood as white patients, surpassing Black and Hispanic people, according to Dr. William Dahut, ACS chief scientific officer.
McArthur with UT Southwestern said clinical trials have historically reflected white, non-Hispanic populations, and that research efforts from organizations, agencies and institutions including hers aim to change that.
“We’re really applying strategies that we’ve learned based on those studies for white, non-Hispanic populations,” she said. “But it could be that Asian, Black, Hispanic populations need different strategies, and we need studies that actually involve those patient populations.”
Black women, despite having 5% lower incidence rates than white women, have a 38% higher mortality rate. In Texas, Black women are less likely to be diagnosed with breast cancer, and more likely to die from it, than white women.
Groups including the Sisters Network of Dallas offer resources, education and financial to African American breast cancer survivors.
Zolean Bruner, the chapter’s president, said her organization also encourages its members to participate in clinical trials.
“It takes a lot of nudging in the community to get us to do that,” Bruner said. “It could be just from fear, just from other things that have been heard through the years about clinical trials … but we’re really pushing for more and more to participate.”
UT Southwestern and other local organizations have also launched initiatives to address socioeconomic barriers that keep high-quality screenings out of reach for historically marginalized communities.
McArthur pointed to UT Southwestern’s RedBird campus, opened in 2022, and the university’s services at Parkland Memorial Hospital, which are available to patients who may not have adequate insurance. Patients at both locations have access to network-based clinical trials.
“There’s a very intentional effort across the network to be attentive to racial disparities and socioeconomic disparities as well,” McArthur said.
Parkland Health offers no-cost mammograms for women in certain Dallas County ZIP codes, as well as a mobile mammography van that visits Parkland community clinics, local health fairs, community events and churches.
Bryana Anderson, a nurse practitioner at Parkland Health, said the report to her is a reminder of the importance of screening and health literacy.
“Women need to know that although mammograms don’t keep cancer away per se, it can save lives by detecting cancer earlier,” she said.
Anderson said she is excited to discuss findings from the report with her patients – especially a 99% 5-year relative survival rate for breast cancer diagnosed early.
“That’s amazing within itself and numbers you don’t get in other cancers,” she said.