Breast cancer: the increasing threat to young Black women - Women's Health Section

IT can become a part of a woman's life when she's too young to drink or vote and certainly too young to run for president. And it can all start with an innocuous lump. Sometimes the lump is barely more than a mosquito bite, sometimes it's larger than a baseball, but its impact has life-threatening implications, whatever its size.

Credit union executive Rebecca McClure of Sacramento, Calif., found a lump in her breast at age 27, but she says she wasn't worried because she told herself, "I'm too young for breast cancer." She was wrong! She was diagnosed with the disease in 2000 and later had a mastectomy and reconstructive surgery. Because the disease was detected early, she did not have to have chemotherapy or radiation and is now taking the medication Tamoxifen. Unlike so many other women, McClure had no family history of the disease, and had never had a mammogram. "Early detection is the key," she says. "Breast cancer is not a death sentence; you have to catch it early."

When it comes to younger women and breast cancer, perception is a real, and potentially deadly, problem. Breast cancer has long been thought of as an older woman's disease. Therefore, the primary focus has been on prevention, detection and treatment of breast cancer for women 50 and older. But in the African-American community, the disease can strike well before physicians and cancer advocate groups recommend that women get baseline mammograms-at age 40.

The Young Survival Coalition, a national non-profit organization dedicated to the critical concerns of young women with breast cancer, provides a wealth of information on young women and cancer. Francie Coulter, national public relations co-chair for the group, says it has several thousand members--some still teenagers--who are breast cancer survivors. More than 11,000 women under age 40 will be diagnosed with breast cancer this year and 1,300 of them will die, according to statistics from the Young Survival Coalition. There are 250,000 women in the United States under 40 living with breast cancer and one in 250 women between the ages of 30 and 40 will be diagnosed in the next 10 years. Although breast cancer is the leading cause of cancer death among young women between the ages of 15-40, the five-year survival rates for women with breast cancer is 82 percent.

But the key to that survival is early detection, and many African-American women don't conduct breast self-examinations and get regular life-saving mammograms. The National Black Women's Health Project recommends monthly breast self-examinations, beginning at age 18, says Lorraine Cole, Ph.D., president and CEO of the National Black Women's Health Project. "I schedule my annual mammogram and annual clinical breast exam with a health care professional during the month of my birthday," Dr. Cole says. "I began the annual mammography ritual earlier than the recommended age of 40 because my mother had breast cancer at a young age.

"African-American women have a high rate of breast cancer, a shorter survival rate after diagnosis and the highest breast cancer mortality rate in the United States," says Dr. Cole, whose mother died at age 44 from breast cancer. "[Black women] are diagnosed with breast cancer at younger ages and often have more aggressive forms of breast cancer."

Sherry B. Williams of Phoenix knows just how aggressive the disease can be. She has battled the disease since 1999 and is a three-time breast cancer survivor, with nearly 20 surgeries since she was first diagnosed. Williams had just turned 40 when her doctor found a lump during a routine physical. She was an unlikely cancer candidate because she had no family history of the disease, didn't smoke or drink, biked regularly and played team tennis. But she did have cancer and eventually underwent a double mastectomy, reconstructive surgery and then the removal of the implants when her body rejected both of them. Then in an ironic twist that shocked even her surgeon, breast cancer was detected at the site a third time. "I was devastated," she says now. "And my surgeon was more devastated than I was."

A fighter, Williams lost her hair and says her insurance has been cancelled during her rounds of chemotherapy and radiation treatments. To make matters worse, her own mother was diagnosed with breast cancer, although she has a milder form. But, the single entrepreneur refuses to give up or give in.

It's been one year since her last round of treatments. She advises women diagnosed with the disease to ask for help and develop a support system. "I call myself 'Miss Independent,' but you need your friends. When you have a chronic illness, it's not just about you." She has also eliminated "90 percent" of the fried foods from her diet--she admits a weakness for fried chicken--and tries to incorporate more raw foods into her diet.

Williams also wholeheartedly preaches the gospel of early detection. She agrees with Dr. Cole who says breast self-exams, in terms of routine, should be like "brushing your teeth or combing your hair."