By: Alexia Achu, Catherine Phamduy, & Yen Phan 1

Transcription

1 By: Alexia Achu, Catherine Phamduy, & Yen Phan 1

2 Female Breast Composition Lobules: milk producing glands Female Breast Anatomy 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. NIH: National Cancer Institute 2

3 Important Definitions Cancer: uncontrolled abnormal cell growth Breast cancer: arises from abnormal cell growth in the breast tissue MRI of a healthy breast (left) versus MRI of a breast containing a tumor (right) 3

4 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 4

5 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 5

6 Why is Breast Cancer Mortality a Health Disparity? 6 African American women have a higher breast cancer mortality rate than the general population in the state of Massachusetts.

7 Breast Cancer Mortality Statistics in Massachusetts Kff.org/state-category/womens-health/?state=MA Year

8 Contributing Factors to Breast Cancer Disparity Socioeconomic -Lack of Transportation -Lack of Education -Poor Health Insurance -Cultural Barrier -Income Lifestyle -Overweight & Obese -Unhealthy Diet Breast Cancer Disparity Access to Health Care -Delay of diagnosis -Delivery of healthcare -Treatment delay -Lack of follow-up Genetic -Triple Negative Breast Cancer 8

9 Socioeconomic Status-Poverty Rate 9

10 10 Socioeconomic Status Quality of Health Insurance Medicaid Coverage Rates for the Nonelderly by Race/Ethnicity in

11 11 Quality of Health Care in Massachusetts Kff.org/state-category/womens-health/?state=MA Year 2013

12 12 Access to Health Care - Treatment Delay in diagnosis Treatment delay Lack of follow-up Poor treatment

13 Lifestyle Obese Based on Body Mass Index by Race in Massachusetts Race State 3-Year % White Non- Hispanic Black Non- Hispanic 21.7 ( ) 30.6 ( ) Hispanic 29.1 ( ) Asian Pacific Islander 8.1 ( ) 13

14 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

15 15 Undoing the Disparity- New 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. Methods

16 Undoing the Disparity 16

17 Summary Mortality rate of breast cancer in MA is higher in African American women Contributing factors Hopes for change 17

18 Questions? 18

19 References Albelda, R., Carre, F., Cheah,E., and Marcellot L. Poverty on Massachusetts by Race, ACS estimates. Center for Social Policy Are there different kinds of breast cancer? Centers for Disease Control and Prevention. 21, Jul Breast Cancer. American Cancer Society. Feb Cancer Health Disparities. National Cancer Institute. 11, Mar Disparities in Breast Cancer Screening. Susan G. Komen. 22, Jan Disparities in Breast Cancer: Through the Breast Cancer-Care Continuum. Breast Cancer Action. Nov Levy, D.E. Underutilization of BRCA1/2 testing to guide breast cancer treatment: Black and Hispanic women particularly at risk. Genetics in Medicine Massachusetts comprehensive cancer prevention and control plan: Massachusetts Department of Public Health. McCormick, Cynthia. Cape breast cancer statistics called scary. Cape Cod Times. 10, Jan O'Keefe EB, Meltzer JP and Bethea TN (2015) Health disparities and cancer: racial disparities in cancer mortality in the United States, 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 :1 Parise and Caggiano: Disparities in race/ethnicity and socioeconomic status: risk of mortality of breast cancer in the California Cancer Registry, BMC Cancer :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 :24 19