SAN ANTONIO – This year is the first that Juneteenth is celebrated as a national holiday, a big win for Black communities nationwide who get to celebrate their freedom and the plight for equality. While freedom rings true, we have a long way to go to achieve true equality, and the proof is in the numbers.
The pandemic brought to light the extreme health disparities that affect Black communities, rooted in systematic racism.
A new study by a local researcher on breast cancer mortality disparities adds to that proof, and the results are not lost on Black patients.
With Lynnette Dawson’s big smile and positive energy, you’d never know she’s been battling cancer since 2018.
“I was going in for a benign consultation on a radial scar and come to find out I had breast cancer on my left breast,” Dawson said.
She went through chemotherapy, radiation and surgery.
Then, in 2021, almost three years exactly after her first diagnosis, came another.
“It’s stage zero breast cancer called ductal carcinoma in situ, so I had my surgery in October,” Dawson said.
As a years-long breast cancer patient and a Black woman, she was disheartened by a recent study released days ago by a research team that includes Dr. Ismail Jatoi, an oncology professor with UT Health San Antonio’s Mays Cancer Center.
The study found breast cancer deaths are 40% higher for Black women than white women.
The research was based on two papers Jatoi published on the same subject in 2003 and 2005.
“Prior to 1980, Black women actually had lower death rates than white women. In 1980, the mortality rates diverged,” Jatoi explained.
Mammograms and endocrine therapy treatment were introduced in the ‘80s. However, access wasn’t equal, and it still isn’t.
“Black women have lower rates of health insurance, and therefore have less access to these interventions,” Jatoi said.
Those interventions also don’t work as well on the most aggressive types of breast cancers, which are more common in Black women.
Jatoi believes that also has to do with access and environment, not genetics.
Estrogen receptor (ER) positive and estrogen receptor (ER) negative are different types of tumors.
The main distinction is how they respond to treatment. ER-positive tumors respond far better to detection and available treatments.
Jatoi’s research has shown further distinctions in ER-negative cancers, despite race.
“Poor white women seem to have higher rates of ER-negative compared to those who are more affluent,” he explained.
That’s why he said there must be something beyond genetics.
The same thing goes for triple-negative breast cancers -- a diagnosis of ER-negative, PR negative, and HER2 negative -- which are much more common in Black women.
Jatoi said closing these gaps lie with awareness and access to care.
“I’m in a good health care plan with my employer, so I have lucked out,” Dawson said. “It is very, very expensive even with good insurance. My out-of-pocket expenses, I’ve maxed it out now twice with my treatments.”
She knows true equality lies with an even playing field.
“We need more foundations that are willing to give treatments to people that are in that situation where they don’t have the health care coverage or enough money to hit deductibles,” Dawson said.
Dawson hopes allies and advocates will take studies like this seriously on the Juneteenth federal holiday.
“It’s great to say that we have that Black freedom, but we also need to educate the community that here are resources to do things and how do we get it to them,” she said.
Jatoi will continue researching this subject with his two fellow researchers from the American Cancer Society.
The goal is to get a clearer picture of how access affects these rates so that advocates can develop better solutions.
As for Dawson, she is continuing her treatment and regular checkups. She said she wouldn’t be considered in remission until no cancer is detected for five years.
She wants women to know her first bout of cancer was detected just two months after a clear mammogram, showing how fast these cancers can grow and spread. That’s why she hopes women will schedule their mammograms.
Doctors recommend yearly mammograms for women ages 45 to 54.
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