Life after breast cancer: Too many black women don’t receive follow-up

February 17, 2014 | by

As the nation commemorates Black History Month, a City of Hope researcher is calling attention to the fact that a shocking 15 percent of African-American breast cancer survivors do not receive annual follow-up mammograms after their treatment stops.

Breast tumor

Black breast cancer survivors are not receiving regular mammograms, a basic component of follow-up care. City of Hope researchers are developing tools to help ensure they get the support they need during the follow-up phase of treatment.

“We did a preliminary study that informed our current survivorship study – and so many African-American breast cancer survivors were not getting basic minimal follow-up surveillance,” said Kimlin Tam Ashing, Ph.D., founding director of the Center of Community Alliance for Research & Education. “Also, patients were not being educated about their treatments, possible side effects and how to improve their symptom management and self-care to enhance their survivorship.”

Among the health disparities faced by black women – and by Latina women – is a greater-than-average risk for more serious disease and death from breast cancer. In addition, black women face an increased risk of premenopausal breast cancer, delays in diagnosis and treatment, and a lack of follow-up care.

Survivorship care plans are now the standard of care, according to the Commission on Cancer, and Ashing and her team are evaluating how to tailor these plans to various ethnic groups. 

“Given that African-Americans and Latinas have more and greater severity of overweight and obesity, as well as chronic illnesses that occur with their cancer, follow-up care for breast cancer survivors has to be integrated with the care they receive from other providers who treat other chronic illnesses – to reduce the risk of cancer coming back or spreading, treatment side effects and risk of new chronic illnesses,” Ashing said.

Ashing urges breast cancer patients to communicate with their health care team about the following issues:

  • Breast cancer treatment's effects on other parts of the body. These effects can involve the heart, bones, eyes, teeth, gums and hormonal function. It can also lead to menopause, cause hot flashes or interfere with fertility. Women need to make all of their health care providers – even optometrists and dentists – aware of the care they're receiving.
  • Short- and long-term treatment side effects. All are possible, including lymphedema, hot flashes and fatigue.
  • Symptom management. Although hot flashes and fatigue can seriously affect quality of life, they can be managed. Unfortunately, many women never mention these issues or receive help from their doctors to take care of these conditions.
  • Quality of life. Many survivors find they need spiritual guidance, help sleeping, stress management strategies and counseling. Resources for managing these important issues should be part of a survivorship care plan – and health care providers should be able to assist in identifying these resources.
  • Steps you can take on your own. Learning how to eat healthy and easily increase physical activity can lead to big differences in quality of life after cancer care. So can keeping up with vaccinations and drinking enough water.

By ensuring that all these factors are addressed in survivorship care plans, women will not only improve their health, they'll also improve their quality of life.