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Racial Disparity in Breast Cancer


Breast cancer rates among white women are higher than those for minority women, but black women are more likely to die from breast cancer. This article explains racial disparities in breast cancer and ways women can reduce their risk.

The basics of breast cancer

Breast cancer is a disease that causes cells in the breast to grow out of control. Breast cancer is the second most common cancer in women in the U.S. (after skin cancer). Deaths from breast cancer have declined over time, but remain the second leading cause of cancer death among women overall and the leading cause of cancer death among Hispanic women. Black women are 40% more likely to die from breast cancer than white women.

What puts you at risk

Your risk for breast cancer is due to a combination of factors. Some are lifestyle issues ‒ such as lack of exercise, obesity, and alcohol use ‒ but the two main factors are ones you can’t control: being a woman and getting older. Most breast cancers are found in women who are 50 years old or older. Your risk is also higher if you have a family history of breast or ovarian cancer.

Differences in breast cancer by race

  • White women are slightly more likely to develop breast cancer than black, Hispanic and Asian women.
  • Among older women, white women have higher rates of breast cancer compared to black women.
  • Black women are more likely to develop more aggressive, more advanced-stage breast cancer that is diagnosed at a young age.
  • Black women are more likely to have breast cancer diagnosed later when treatment options become limited and the survival rate is poor.
  • Genetic factors may make black women more susceptible to certain types of cancer.
  • Lifestyle factors – such as being overweight and not exercising – are linked to higher risk.
  • High rates of type 2 diabetes in black women may be a factor. Women who had been diagnosed with diabetes at least five years prior to their breast cancer diagnosis were almost twice as likely to die of the breast cancer.
  • Economic factors, such as lack of health insurance, limited access to medical care, and lack of access to nutritious foods, may contribute to higher cancer risk in minority women.
  • Women who don’t breastfeed are at higher risk. Breastfeeding rates are lower among blacks than whites.

While there may be some factors you can’t control, such as a family history of breast cancer, there are steps you can take to lower your risk, whatever your race:

  • Maintain a healthy weight. Ask your doctor about healthy ways to do this.
  • Be physically active. Most healthy adults should aim for at least 150 minutes a week of moderate aerobic activity or 75 minutes of vigorous aerobic activity weekly.
  • Limit alcohol. Limit yourself to no more than one drink a day, as even small amounts increase risk.
  • Breast-feed. The longer you breast-feed, the greater the protective effect.
  • Limit postmenopausal hormone therapy. Talk with your doctor about the risks and benefits of hormone therapy.
  • Get screened. The American Cancer Society recommends women 45 to 54 get mammograms every year, and women 55 and older get them every one to two years.

Learn more about breast cancer and what you can do to lower your risk.

Tracy Jansen, M.D.Dr. Jansen is an MPCP partner and is certified by the American Board of Family Medicine. She cares for patients at the Pasadena office.

To ‘G’ or not to ‘G’: Should you go gluten-free?

The gluten-free diet is the latest nutrition craze. Books, articles and TV shows tout the benefits of axing gluten, and it’s hard to walk down the grocery store aisle without encountering a raft of gluten-free products. A survey by Consumer Reports shows over 60% of Americans think that going gluten-free can improve their physical and mental health.

Advocates claim avoiding gluten leads to better digestion and gastrointestinal function, weight loss, higher energy, lower cholesterol, and a stronger immune system. There are even products to help you “detox” your body from gluten, suggesting that it is harmful.

So what is gluten, and are there health benefits to going gluten-free?

Gluten refers to a protein found in wheat, barley and rye. Cutting gluten out of your diet means cutting out gluten-containing bread, soup, pasta, cereal, and virtually any food or drink containing wheat, barley, rye or triticale (a newer grain with a similar quality as wheat).

There are people who definitely need to avoid gluten. Those with celiac disease ─ around 1% of Americans ─ may experience severe inflammation and damage to the lining of their small intestine. Even a small amount of gluten can cause bloating, cramping or skin rashes. Other people, who have gluten intolerance or sensitivity, do not suffer intestinal damage but may experience headaches, bloating, fatigue or diarrhea after eating foods with gluten.

For this relatively small group of people, a gluten-free diet functions as a detox diet by relieving their system of an irritant, and it can make a significant improvement in their quality of life.

For everyone else, research does not support the idea that cutting out gluten promotes good health. In fact, there are some good reasons not to go gluten-free:

Because wheat is ubiquitous in the American diet, completely eliminating gluten requires adopting a whole new diet. You would have to give up most breads, crackers, breakfast cereals, conventional pastas, pastry goods, beer and a wide range of processed foods made with small amounts of gluten.

Whole grains, which contain gluten, are rich in an array of vitamins and minerals, such as B vitamins and iron, as well as fiber. Studies show that whole-grain foods may help lower the risk of heart disease, type-2 diabetes, and some forms of cancer. The government’s Dietary Guidelines for Americans recommends that at least half of all carbohydrates in your diet come from whole-grain products.

A report from the American Dietetic Association warned that gluten-free products tend to be low in a wide range of important nutrients, including B vitamins, calcium, iron, zinc, magnesium, and fiber, so eliminating them may contribute to a nutritional deficiency.

Gluten-free does not automatically equal weight loss. Some gluten-free products make up for gluten by adding sugar and fat. In fact, a review of studies published in the Journal of Medicinal Food revealed that a gluten-free diet seems to increase the risk of overweight or obesity.

Most gluten-free alternatives, such as pasta and bread, are significantly more expensive than their conventional counterparts. A 2007 survey found that gluten-free pastas and breads were twice the price of conventional products, for instance.

If there are no proven benefits to a gluten-free diet, why do some people swear by it? It’s possible that, in addition to cutting out gluten, these people also make other, healthy changes, such as eating more fruits, vegetables, and lean meats, and fewer desserts and junk foods. These changes would naturally lead to feeling better and losing weight.

So, if you suspect you may have celiac disease or are gluten intolerant, see you doctor for testing and a diagnosis. If not, enjoy your gluten.


Tracy Jansen, M.D.Dr. Tracy Jansen is an MPCP partner and sees patients in the Pasadena office. She received her medical degree from Virginia Commonwealth University School of Medicine and completed her residency program in Family Practice at the Medical College of Georgia. She is certified by the American Board of Family Medicine.