Triple-Negative Breast Cancer Puts Me in a Minority

(WOMENSENEWS)– It didn’t make sense. The fact that I had breast cancer was difficult enough to absorb, but when I learned that risk factors for triple-negative breast cancer, the type I had, included being young (pre-menopause) and African American or Latina, I was really perplexed.

I am a 71-year-old healthy white woman, with no history of cancer of any type in my immediate family.

African American women as a group have lower rates of breast cancer than do white women; but are more likely to die of it. A recent study found black women in Los Angeles were 70 percent more likely to die from breast cancer than white women.

Among other reasons, these women were less likely to get regular mammograms and, although the gap has closed in recent years, it may also be that access to follow-up care is more difficult to arrange for women of color than for white women.

Latinas actually have lower rates of breast cancer than other groups, but breast cancer is still the most common form and most likely to be deadly in that group.

Recent data show that Hispanic Americans were more likely to lack health insurance in 2013, with non-Hispanic blacks also more likely than whites to be without coverage. Obamacare should eventually reduce these disparities, but it will take some time to assess the full impact.

Attacks by anti-abortion groups against Planned Parenthood in states like Texas could make the situation worse by reducing screening programs for women who can’t afford them otherwise.

Unequal Access to Care

My connection to women of color in getting this disease has reminded me that others who share my diagnosis don’t necessarily share my access to care, and that is unacceptable in the United States in the 21st century.

Mammograms should be universally available at no cost to all women, and targeted advertising should alert women to the importance of this procedure. A program should be implemented so that when breast cancer is diagnosed – perhaps a form of short-term medical disability coverage – my sisters of color are afforded the same opportunities to beat this devastating disease as I had.

Triple-negative breast cancer means that the cancer cells do not have the three known receptors that fuel cancer growth, so the treatments that are used for those more common forms of breast cancer aren’t effective for triple-negative.

Scientists do not yet know why women of color have higher risks for triple-negative breast cancer. This type of cancer is often more aggressive, with higher rates of recurrence, than other types of breast cancer.

I was lucky. I had excellent insurance coverage through my employer. I’m a professor and can frequently work at home on my research and writing, and I was able to adjust my schedule so that I could do my job during treatment with minimal modification. My boss readily agreed to those schedule changes.

I had access to top-notch health care. My surgeon and oncologist both had Ph.D.s in addition to M.D.s, so they were aware of the most up-to-date research on triple-negative breast cancer and prescribed the most appropriate treatment regimen.

16 Chemotherapy Treatments

That involved 16 chemotherapy treatments (four with one cocktail and 12 of another), followed by a lumpectomy, and then daily radiation treatment for 33 days.

Since my tumor was effectively eliminated by the chemotherapy (and no others were found), I was able to have a lumpectomy instead of a mastectomy, and my prognosis is positive.

It’s now over a year since my initial diagnosis, and all indications are that I am cancer-free. My hair has grown back, my porta-cath is now only a faint scar and I feel strong and energetic.

The cost of my treatment was shocking, but I didn’t have to lose my home to afford it. My insurance covered most of the costs, and my co-pays were manageable.

When people learn I have had cancer, they often ask whether I gained a new perspective on life.

I think the answer they anticipate is "Yes, I am now acutely aware of my own mortality and have committed to spending my remaining time on what is important to me." Perhaps because of my age, these insights were not new.

What I did come to understand is that I was very privileged to get the very best care, so that at no time did I think I had received a death sentence.

My strong hope is that all women, regardless of color, will have the same access to highly qualified physicians and the best care available. I want them all to be able to say with me, "I am strong and cancer-free."