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Q&A: African-American women face greater breast cancer risks

TAMPA — Sonia Franklin was diagnosed with breast cancer in 1999. She was treated successfully, but set out to educate herself about the condition.

In 2008, she learned at a conference about something she had not heard of: triple negative breast cancer, a particularly aggressive form found more often in women of African descent.

A year later, Franklin again had breast cancer — and this time it was triple negative.

"To say I was shocked is an understatement," said Franklin, 51. She had a mastectomy, had chemotherapy, went into remission and then was told the cancer would likely recur. In 2012, it did. Now, she is again in remission.

Today, the Seffner woman leads the local chapter of the Sisters Network, the group that brought the condition to her attention.

"It's our goal to let people know that we're here to help," said Franklin, who along with others asked the Houston-based group to take its education program on the road. Its first Tampa conference is Saturday; registration is open until Wednesday.

Breast cancer has historically taken a particularly heavy toll on black women. Lower incomes and poor access to early screening and care have long been blamed, but now researchers say there is more to the story.

"Now we understand more about the biology of the disease and how it affects black women in particular," said Dr. Lisa Newman, national medical adviser to the Sisters Network Inc.

Newman, who directs the Breast Care Center at the University of Michigan Comprehensive Cancer Center, spoke with the Tampa Bay Times about what science is learning about breast cancer in African-American women.

What, in particular, do African-American women need to know about breast cancer?

That African-American women tend to be younger at diagnosis of breast cancer—57 compared to 62 for white women — and that they are at higher risk for a more challenging type of breast cancer called triple negative. This type is more likely to recur, mortality is higher and it is more likely to be diagnosed at a younger age.

What is triple negative breast cancer?

When we diagnose breast cancer, we usually look for three primary receptors in the tumor and they are important because they determine the patient's prognosis and what type of treatment we can offer. Most breast cancers have either estrogen receptors, progesterone receptors or the (human epidermal growth factor receptor). We have good treatments for these three. But some patients are negative for all three of these markers and we call that triple negative. While it does respond to chemotherapy, we don't have good targeted therapy for it yet.

How common is it?

For American white women, triple negative accounts for about 15 percent of breast cancers. But that frequency doubles in African American women. Triple negative accounts for 50 to 75  percent of breast cancers in Sub-Saharan African women. That's why breast health awareness is so important for women of African descent.

Are women getting the message about screening?

Thanks to groups like the Sisters Network, they are getting the word. We have seen improvements in rates of mammography where historically it was low. But compliance did take a hit in general due to the recent economic downturn and in 2009 with the recommendation from the U.S. Preventive Services Task Force telling women to put off breast screening until age 50, which created a lot of confusion and sent a dangerous message. If you have triple negative breast cancer and you've delayed screening until age 50, it could impact survival. So the Sister's Network and the American Cancer Society continue to recommend annual mammograms starting at age 40, maybe earlier if there's a strong family history of breast cancer.

What more do African-American women need to know about breast cancer?

The other important message is the need for their participation in clinical trials and research. We know very little about the risk factors for triple negative breast cancer. We think it has something to do with African ancestry, possibly something to do with child bearing. All that points to the need for more research and more African-American women getting involved. This is how we will make improvements.

. IF YOU GO

National African American Breast Cancer Conference

Saturday, 10 a.m. to 2 p.m., Public Services Technology Building, Hillsborough Community College Ybor Campus. Speakers include Tampa breast surgeon Sylvia Campbell and Moffitt oncologist Hyo Sook Han. Cost is $25. Register by Wednesday at

sistersnetworkinc.org.

Q&A: African-American women face greater breast cancer risks 07/21/13 [Last modified: Sunday, July 21, 2013 11:11pm]
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