EXPERT INTERVIEW
Racial Disparities in Breast Cancer An interview with Aminah Keats, ND, FABNO
In this interview, our editor-in-chief, Tina Kaczor, ND, FABNO, speaks with Aminah Keats, ND, FABNO, about breast cancer disparities in African American women. Keats is a practicing naturopathic physician at Capital Integrative Health in Bethesda, Maryland, and is also vice president on the board of directors for the Oncology Association of Naturopathic Physicians (OncANP). You can find Keats on Facebook and on Instagram @draminahkeats or at her website: drkeats.com.
Play Now Approximate listening time: 37 minutes
Tina Kaczor, ND, FABNO: Let’s start by talking about incidence and mortality from breast cancer. What is the latest data telling us? Aminah Keats, ND, FABNO: This topic is something that is just so near and dear to my heart. I’m so happy to be here and to participate in this discussion. When it comes to breast cancer incidence, the percentages of White women compared to Black women are pretty close. White women have the highest incidence of breast cancer, and Black women closely trail behind. Now, when you look at that same data from 10 or 20 years ago, that gap was wider, but that percentage has increased for Black women. But when you look at the mortality rates, numbers differ pretty significantly. The death rate from breast cancer is about 40% higher in Black women compared to White women. So that gap is pretty significant, and that has actually been pretty consistent over the last several decades.
“
When you look through
the literature, the socioeconomic piece is probably the most commonly named factor that we see. But what’s interesting is when we look at some of the data, even when that is accounted for, there’s still a racial difference.
”
is most commonly diagnosed in women across the board of all races and ethnicities. That subtype has the best kind of prognosis. However, that particular subtype is lowest in Black women, which is very interesting. It’s definitely something to pay attention to. We know that the most aggressive subtype is triple-negative: ER-negative, PR-negative, and HER2-negative. That is the most aggressive, with the poorest prognosis, and that is actually highest in Black women.
For women who are aged 40 years of age and younger, the incidence rate actually flips—the percentage of breast cancer in Black women is higher compared to White women. However, that mortality gap across the board is consistent.
So out of the breast cancers diagnosed in Black women in this country, triple-negative disease actually accounts for about 20% to 21%, and that is probably about double compared to other populations in this country. Obviously that plays a role in the disparity.
Kaczor: We know there are certain things that are predictive or at least a prognostic indicator for women. There are higher rates of death with certain subtypes. Can you talk a little bit more about cancer subtypes and the direction that the data goes?
Kaczor: It’s poignant to hear Black women under the age of 40 have a very high rate of death from breast cancer compared to their White counterparts. Is there any advice you would give clinicians for their young Black patients? Should we be screening earlier?
Keats: When it comes to that tumor and biology piece, when we look at the subtypes, ER-/PR-positive and HER2-negative
Keats: That’s a really great question. There are no definitive guidelines for that, but there’s definitely a need for more
28 ©2021 NATURAL MEDICINE JOURNAL. ALL RIGHTS RESERVED. NMJ, OCTOBER 2021 SUPPLEMENT—VOL. 13, NO. 101 (SUPPL)
