Despite years of progress in diagnosing and understanding the disease, breast cancer remains a major cause of death among women from all walks of life. And for African American women, breast cancer carries an especially compelling statistic: Although Black women are less likely to contract breast cancer than White women, they're more likely to die from it.
This could be due to lingering economic disparities between African American and European American Women; poor women across the board may not receive regular medical care and are thus less likely to detect breast cancer early — when it's more treatable — and unable to afford effective treatment, said Nathalie Johnson, Ph.D., medical director of the Legacy Breast Health Centers in Portland.
Johnson will be the keynote speaker at this year's 15th annual Survivor Luncheon, the prelude to the annual Susan Komen Foundation Race for the Cure fund-raising run.
The luncheon takes place from noon to 2 p.m. Saturday, Sept. 16, in the Oregon Convention Center, 777 N.E. Martin Luther King Jr. Blvd. It is part of a health expo taking place at the convention center from 10 a.m. to 6 p.m. Sept. 15 and from 10 a.m. to 4 p.m. Sept. 16.
The Race for the Cure steps off at 7:30 a.m. the next day from Tom McCall Waterfront Park.
Breast cancer hits particularly close to home for Johnson, a general surgeon who performs cancer related-surgery, especially breast cancer. As a child growing up in the Virgin Islands, she saw her mother battle breast cancer and win.
"My mom had breast cancer when I was 12 years old," she said. "I don't think I consciously went into this field, but it's a good fit for me. I have a passion for it."
At her luncheon address, Johnson plans to speak about new treatments and surgical options for breast cancer, and about a particular concern of hers — access to care.
"There are working people who don't have good access to care," Johnson said, "and also the federal Breast and Cervical Cancer Program recently ran out of funds. So we lost a really good means of getting treatment for lots of women."
Even though the lack of federal funds has been a setback in access to care, Johnson said there are other resources available to lower-income women, including the Komen Foundation itself, which operates a screening program for people who are uninsured or under-insured.
Because of the harsh socioeconomic factors that often determine who receives breast cancer treatment and who doesn't, Johnson said that prevention is a critical component in the fight against the disease. One of the easiest, most effective — and by far the cheapest — means of prevention is one that every woman can learn: breast self-exam.
"It's critically important," she said. "There's a large number of women who are diagnosed because they felt an abnormality in their own breast."
The earlier a cancer is detected, the easier — and less invasive — its treatment. The Komen Foundation recommends that women, beginning at age 20, examine their breasts monthly. Ideally, this should be augmented by regular breast examinations from a doctor, and regular mammograms after age 40.
Performing a thorough breast self-exam is mainly a matter of education and practice, Johnson said. A doctor can teach you, and many instructional materials are available online and in print.
"There are plenty of women who know about self-exam but don't do it," Johnson said. "They just don't think that breast cancer would ever happen to them."
The overall risk of breast cancer is startlingly high: One in seven women, regardless of background, will come down with the disease at some point in their lives. The precise cause of breast cancer remains unknown, but a growing number of factors that can increase the risk have been identified, including:
• Getting older: The older you are, the higher your risk;
• A personal history of breast or ovarian cancer;
• Having a mother, daughter or sister who has had the disease;
• Being young (under age 12) at the time of your first period;
• Starting menopause after age 55;
• Never having children or having your first child after age 30;
• Being overweight as an adult, especially after menopause; and
• Taking birth control pills for five years or more.
Breast cancer rates worldwide are higher in industrialized countries than in developing nations. Johnson attributed this anecdotally (there's no hard evidence) to dietary and environmental factors — there are more synthetic chemicals in food and in the environment in industrialized nations than in other places.
"Personally, I think it's a change in our dietary habits and in the way our food is produced," she said. "That's just my personal theory — I don't really have science to back it up."
Because there's so much more to be learned about breast cancer — and because there isn't yet a cure — events like the Komen Race for the Cure are essential to the cause, Johnson said, especially at a time when federal funds for research and treatment are in short supply.
"Komen is one of the largest funders of breast cancer research," Johnson said. "Initially, a lot of the funding was focused on treatment, but now there's a much greater focus on prevention. Quality of life for therapy after treatment has really expanded."
While the deadline for teams to register for the race has passed, individuals can still register online until noon on Sept. 14. In-person registration is available the day of the race, at the health expo and at local GI Joe's and Nordstrom stores through Sept. 13.
For registration and race information, visit www.komenoregon.org. To learn more about breast cancer risks, prevention and treatment, visit www.komen.org.