Rifat Wahab, DO, assistant professor of radiology at the University of Cincinnati College of Medicine, specializes in breast imaging at UC Health. She attended the Michigan State University College of Osteopathic Medicine.
While in school, she specialized in diagnostic radiology and served as a chief resident at Henry Ford Hospital/Michigan State University Consortium. As she continued her education, she spent time learning more at Vanderbilt University Medical Center in Nashville, Tennessee, in the Women’s Imaging Department. One of Dr. Wahab’s passions is to include diversity and inclusion within her practice. Outreach is important to her, along with educating the public on the signs of breast cancer and ways to identify it.
How does breast cancer affect African American women vs. white women?
African American women have a similar occurrence rate of breast cancer as white women. However, despite advancements in screening and treatment, African American women have a 39% higher death rate than white women.
Several factors play into this higher death rate, which include:
- Genetics.
- Tumor biology.
- Access and time of screening.
- Access to treatment.
There is a higher incidence of breast cancer in African American women before the age of 50, and these younger African American women experience a higher risk for breast cancer morbidity and mortality.
At what age should African American women get a mammogram?
Every woman, at a minimum, should have a screening mammogram at the age of 40 and every year thereafter. If a woman has an elevated risk for breast cancer, they may begin screening sooner. African American women should have discussions with their primary care provider by the age of 30 to identify risk factors that could predispose them to breast cancer and if they need to begin screening sooner. In addition, those women at an elevated risk may qualify for additional screening beyond a mammogram such as a breast MRI or ultrasound.
It should also be noted that screening guidelines that recommend a delay in screening mammogram at the age of 50, such as the USPS Task Force, is based on data from a population that was predominately white. If African American women follow those guidelines, it puts them at a disadvantage and can contribute to a delayed diagnosis, as there is a higher incidence of breast cancer in African American women 50 and younger.
Is breast cancer deadly to African American women?
Breast cancer can be deadly for all women if not diagnosed at an early stage. African American women are less often diagnosed with stage 1 breast cancers, and have a higher incidence of triple negative breast cancer at 21%, compared to white women at 10%. This may be related to the aggressive tumor biology in particular to triple negative breast cancers, which have rapid growth, limited treatment options and higher chance of recurrence. Triple negative breast cancers are more common in African American women than other women.
Should women continue to do self-exams?
All women should continue to do self-breast exams! No one will know your breasts better than you! Do your breast exam at the same time every month and note any changes. If you feel a lump or a change, call you doctor immediately for an evaluation. Mammograms detect approximately 70-80% of breast cancers, but not all; hence, your self-exam is very important.
How do you perform a self-exam?
Here are some common ways to perform a self-exam:
- Lay down – Find a flat surface or bed, and lay on your back. While lying flat, the breast tissue spreads out and it is easier to feel.
- In the shower – Make sure your fingers are lathered with soap. Soap helps you move over your skin to feel for any lumps.
While examining your breasts:
- Use the pads of your three middle fingers – not the tips.
- Use different pressure during your exam. This helps you learn the different depths of your breast.
- Do not rush – Take your time so you do not miss anything.
- Create a pattern and follow it each time. By doing this, you know you will examine your entire breast.
What else should I know?
Have conversations early about your breast health with your primary care providers. Understand your risk for breast cancer by asking women and men in your family about their history of breast cancer, biopsies and other cancers. The more informed you are about your breast health is key in early detection for breast cancer. When you notice a change in your breast, do not wait to get it checked out! Do it immediately. At a minimum, get your mammogram at the age of 40 and every year thereafter. Finally, encourage your family and friends to get checked, too!