African American women face a lower risk of being diagnosed with breast cancer as compared to Caucasian-American women, yet they paradoxically face an increased breast cancer mortality hazard. This breast cancer health disparity is due primarily to the occurrence of an early-onset “triple-negative” [estrogen receptor-negative, progesterone receptor-negative and Her2-negative] breast cancer phenotype prevalent in African American women less than 35 years of age. This type of breast cancer is very aggressive, has a poor prognosis, fails to respond to conventional therapy, and stains positive for mutant-p53. The etiology and biological basis of the triple-negative breast cancer phenotype in African American women is currently unknown but is likely to be multi-factorial. There are models that predict the intersection of disparities and the aggressive biology of breast cancer in African American women. Some factors that probably play a role in the disparity are unsafe neighborhoods, access to healthcare, co-morbidities, reproductive factors, and socioeconomic statuses. Another major factor that has been revealed as a primary driver of the high mortality rate of triple negative breast cancer is the high risk of recurrence and the development of chemoresistance to therapeutic drugs such as doxorubicin. We will explore the role that these factors play in breast cancer health disparities as a way to reduce their influence on driving increased death rates.
1. Define breast cancer health disparity.
2. List at least three risk factors associated with breast cancer health disparity in African American women.
3. Discuss the role that chemoresistance play in driving breast cancer health disparities.