Educated Patient® Metastatic Breast Cancer Summit Addressing Breast Cancer Disparity Presentation: November 12, 2022

Disparities in the care of patients with breast cancer is important not only for health care providers to be aware of, but also patients, as they can play a role in empowering others to undergo screening and treatment, an expert said.

Dr. Beverly Moy, clinical director of the breast oncology program and director of cancer equity at Massachusetts General Hospital in Boston, discussed breast cancer disparities during a presentation at the CURE® Educated Patient® Metastatic Breast Cancer Summit.

“The fact is that if you are from certain underserved patient populations, you're far more likely to die of breast cancer compared to more advantaged populations,” Moy said in an interview with CURE®. “For example, if you're a Black woman diagnosed with breast cancer, you're about 40% more likely to die of breast cancer compared to White women. And it's even worse, if you're a young Black woman below age 50 diagnosed with breast cancer, you're twice as likely to die of breast cancer.”

Moy mentioned that it is the role of the oncology community to provide information to patients and caregivers, which can empower them to get screened for breast cancer, as earlier detection may improve cure rates. It is also critical for the community to empower patients to seek quality cancer care.

“We are making huge strides in advancing breast cancer outcomes and improving survival,” Moy said. “We want to make sure that all of our patient populations benefit from those treatments.”

Why Disparities Persist

Over the last decade, breast cancer survival rates have improved at approximately 3% per year in women of all races, Moy said. Despite these treatment advances, the disparity gap in survival between White women and Black women, among other groups, remains constant.

“There are a myriad of reasons, but we believe the most important reason is access to care,” Moy told CURE®. “Certain disadvantaged populations have reduced access to quality health care, whether it be due to not having health insurance, being underinsured or perhaps having insurance that doesn’t allow for treatment in a quality facility close by.”

In fact, several studies have down that patients from disadvantaged populations are less likely to get the correct treatments after receiving a diagnosis of breast cancer such as antiestrogen treatment or radiation, Moy added.

Also, patients from disadvantaged populations often don’t have access to clinical trials at the centers they are receiving care from, even though that “clinical trials after often the very best treatment option we can offer,” she said.

What Can Be Done

Moy explained how patients should advocate for themselves when it comes to finding the proper center to obtain treatment in a timely manner and also educate themselves on all available treatment options before making a decision. Advocacy should also be done on a population level to increase awareness.

“What we really need to do is to advocate for policies that help our underserved patient populations the most,” Moy said. “And where I think a lot of us have focused on — and rightly so — is reform of Medicaid, the federal insurance product. … That (differs) state by state. There are certain decisions that some states have made (on) whether or not to expand Medicaid or not.”

Moy also urged patients to ask their treating oncologist about clinical trials that may be available to them, whether it be at the center they are visiting or another one. Patients can also check ClinicalTrials.gov, where they can search by disease for trials available to them. She also said that obtaining a second opinion may also help guide treatment decisions.

“Request a second opinion at a site that offers clinical trials,” Moy said. “Certainly that is something that is very welcomed. The primary oncologist or treating oncologist often appreciates having input from others. It doesn't offend anyone to get an additional opinion. It's really all about the patient and wanting them to feel secure with the treatment that they're getting.”

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