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Mammogram Screening Guidelines Don’t Help Black Women

New York Governor Andrew Cuomo took a step in the right direction to facilitate early detection of breast cancer by signing a bill into law. This new bill, Shannon’s Law, named in honor of Shannon Saturno because she was diagnosed with breast cancer at age 28 while pregnant with her daughter, mandates that insurance companies be required to provide mammogram screenings for individuals ages 35 and older.

This legislation represents a change from the current mammogram screening guidelines of the American Cancer Society: “Women ages 40 to 44 should have the choice to start annual breast cancer screening with mammograms (x-rays of the breast) if they wish to do so. Women age 45 to 54 should get mammograms every year. Women 55 and older should switch to mammograms every 2 years or can continue yearly screening.”

This new law is great news for white women, and we know it will save lives. But the impact of this law will not readily help African American women. According to the American Cancer Society, black women younger than age 35 get breast cancer at two times the rate of white women and die from breast cancer three times as often as white women.

Breast cancer is the most imperative health issue for African American women. Though we get breast cancer at a slightly lower incidence rate than white women, black women, across all ages, are 42 percent more like to die of the disease. 

In March 2018, the American College of Radiology and the Society of Breast Imaging recommended that black women be added to groups considered at high risk for breast cancer because of the higher mortality rate. This was the first time black women have been classified as a high-risk group. The ACR/SBI supported that all women, especially black women, should be evaluated for breast cancer risk no later than age 30 so those at higher risk can be identified and benefit from supplemental screening. Their mammogram screening guidelines also recommend women at high risk for breast cancer, i.e., black women, have screening more frequently, and with a different screening method, such as MRI or ultrasound. So a woman at high risk might have a mammogram at the beginning of the year, and then have an MRI six months later.

The American Society of Breast Surgeons takes an even more aggressive approach, recommending that risk assessment actually be done at age 25 as the first step to determining the appropriate mammogram screening guidelines. Furthermore, the ASBrS “acknowledges the presence of breast cancer outcome disparities in the U.S. African American women, for example, face a disproportionately high risk of breast cancer mortality, which is at least partly explained by differences in stage distribution as well as tumor biology. These screening recommendations for the overall diverse population of adult women represent an opportunity to minimize breast cancer disparities through earlier detection of disease in all women.”

“Black women are at high risk for breast cancer,” said Valarie Worthy, president of Sisters Network Inc. Triangle, North Carolina Affiliate Chapter. “I wholeheartedly support getting a risk assessment at age 25.”

Gov. Cuomo understands the importance of early screening. “We know that with cancer diagnoses, early detection is the best possible treatment,” he said. “This administration has taken and will continue to take aggressive action to break down any barriers to breast cancer screenings for women across the state.”  

But early detection is not happening sufficiently for black women. According to the American Cancer Society, 65 percent of white women are diagnosed at an early stage versus only 55 percent of black women. Nearly twice as many black women are diagnosed with late stage breast cancer versus white women.

“Frankly, if black women are at high risk for breast cancer, have a higher mortality rate and are diagnosed at later stages, it only makes sense that the screening guidelines be different and address these factors,” said Karen Eubanks Jackson, founder and CEO of Sisters Network Inc.”In fact, 25 years ago when I founded the organization, our guidelines were geared to saving the lives of black women. We recognized the disparities and therefore strongly recommended mammography at a younger age.”

Sisters Network appreciates Gov. Cuomo’s efforts that have promulgated a discussion around this critical issue, however, we need to take things a few steps further to save the lives of black women.

“Our leaders need to clearly understand the severity of the health disparities for black women,” said Dr. Regina Hampton, breast surgeon and medical director of the Breast Center at Doctors Community Hospital in Prince George’s County, Maryland. “Breast cancer screening guidelines should allow providers to make appropriate recommendations to meet the needs of their community and population.”

So what can we do? Petition Congress, state and local legislators. Demand laws that protect black women, too. Continue to fight like girls alongside Sisters Network Inc., a sisterhood of survivors and thrivers, and be the voice of black women.

In the meantime, until the world catches up to our reality, black women must take matters of breast health into our own hands. So choose a day of the month each month and check the breasts you love. We know you have a pair.

—Ricki Fairley


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