African American women are referred for fewer breast biopsies after having a mammogram than white women, yet they have a higher rate of unnecessary biopsies or false positive results, according to a study presented here at Touro College Research Day.
Organized by the Touro Research Collaborative, Touro College Research Day is being held on Tuesday, May 3, at the Touro College of Osteopathic Medicine and the Touro College of Pharmacy campus at 230 West 125th Street in Harlem.
"If a woman has dense breasts, mammography is likely to miss tumors and she is more likely to have false positive results," says Joseph Indelicato, PhD, Chair of Touro College Research Collaborative, Touro College School of Health Sciences. "African American women have a higher rate of dense breasts than white women, so I wanted to see if this could be one of the reasons why African American women are diagnosed with later stage breast cancer and have a poorer survival rate," he says.
In this study, women waiting to have a mammography at screening facilities were asked to take a breast cancer risk assessment and to answer 27 questions about previous biopsies. The study included 11,414 women from Long island ages of 35 to 69.
Of the white women, 37.7 percent of those who had received a breast biopsy were diagnosed with cancer compared to only 25.2 percent of African American women who had a biopsy. This suggests that more African American women underwent unnecessary biopsies. White women were also 23.5 percent more likely to be referred for biopsies than African Americans, meaning that mammography is likely missing cancers in African American women. This could potentially lead to African American women being diagnosed with later stage breast cancer. Indeed, white women were 70 percent more likely to have cancer detected than African Americans.
"Black women are getting unnecessary biopsies, and the surgeries are much less useful for them," says Indelicato. "White women, on the other hand, are more likely to get an accurate mammogram."
Women with dense breast tissue are advised to talk to their doctors about having a followup exam, such as an ultrasound, though there are no guidelines that state that these women should get an ultrasound. Some states require screening facilities to inform women that they do have dense breasts and that they should discuss follow up testing with their physicians.
"Before this study, nobody has ever looked at the differential rate of positive biopsies in African American women and white women," says Indelicato. "We want to make doctors and women more aware of the importance of the limitations of mammograms in African Americans."