Breast Cancer Guidelines' Impact On Black Women

White women have higher breast cancer rates overall, but black women get the disease more often before age 40. They also tend to have more aggressive cancers and lower survival rates. That concerns Dr. Marisa Weiss, a Philadelphia oncologist. She tells host Guy Raz how the breast screening recommendations released this week by the U.S. Preventive Services Task Force could have an especially rough impact on black women.

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GUY RAZ, host:

Patient advocacy groups and cancer societies are pushing back hard against the recommendation made by a federal task force on breast cancer screening this past week. The U.S. Preventive Services Task Force now says mammograms are unnecessary for women under the age of 50, and then only every two years.

Dr. Marisa Weiss is an oncologist and the founder of Breastcancer.org, and she joins us from Philadelphia.

Welcome to the program.

Dr. MARISA WEISS (Founder, Breastcancer.org): Thanks for having me.

RAZ: Dr. Weiss, you have publically expressed that you worry that these recommendations will have a devastating impact particularly on African American women. Why is that?

Dr. WEISS: Yes. Well, because already, African American women experience this disease uniquely. They are more likely to get breast cancer under the age of 40. They are not using - utilizing the benefits of early detection as much as other women do. They have cancers that are more - tend to be more aggressive. For example, this cancer called triple-negative breast cancer. That's about two to three times more common in African American women and that comes with a much more aggressive, life threatening type of cancer.

And so if these women, if they don't start getting their mammogram at age 40, then we will have missed the opportunity, I believe, to save their lives.

RAZ: What about survival rates among women who are diagnosed with breast cancer, the differences between African American women and Caucasian women?

Dr. WEISS: Well, in the years between 1996 and 2004, for example, African American had a 77 percent survivorship, five-year survivorship compared to 90 percent among whites.

RAZ: So what you're saying is that because African American women are at higher risk of developing breast cancer often under the age of 40 that the recommendations by the taskforce will be sending a message that they no longer should be screened until the age of 50, and that's the risk.

Dr. WEISS: Yes. That's what I've been hearing this past week. We've seen a significant cancellation rate for mammograms at our hospital and...

RAZ: Because women are basically saying: Well, I shouldn't do this until the age of 50.

Dr. WEISS: That's right.

RAZ: Dr. Weiss, there's significant evidence to show that among women who are screened that there's a disproportionate number of African American women in this country who are not routinely tested. I mean, why will the taskforce recommendations change that anyway if this is already a problem?

Dr. WEISS: Well, it's going to make the problem worse because doubt has been inserted. For them to go out of their way now to get a mammogram when they may not have health insurance, to pay out of pocket for something, there's a doubtful value from what they heard this week will deter their coming forward and getting a mammogram.

RAZ: Some of the loudest opponents of these recommendations have been radiologists. And some critics of these opponents have said, well, look, you know, radiologists have a stake in mammography. What do you say to folks who make that argument?

Dr. WEISS: I understand that there's criticism that the strongest opponents of these revised guidelines are the people who make their living doing mammography. But the benefit of mammography has been demonstrated in clinical trials both randomized clinical trials and population studies. So depriving women of the benefit of mammography punishes the women, not the doctors.

RAZ: Dr. Marisa Weiss is an oncologist and the founder of Breastcancer.org.

Dr. Weiss, thank you so much for joining us.

Dr. WEISS: Thanks for having me.

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