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June 1, 2000
Breast Cancer: Cause and Controversy
Blacks Take the Hit
Breast cancer cases in predominantly black Hunters Point tend to be diagnosed much later than in well-off, white Bay Area enclaves like Marin County.
And fewer African American women survive the disease.
"Women are much less likely to get diagnosed early on in this community, are less likely to have regular mammograms, and when they get the disease the outcome is worse. They don't do as well," Luce said.
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You lose your breasts, lose your hair. There are stigmas attached to that, for African American women especially. | |
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At SF General, providing mostly last-resort health care to the uninsured, fewer than 10 percent of breast cancer cases are picked up in situ, while only 30 percent were found at in the invasive stage.
Hard Numbers
Although breast cancer is most commonly diagnosed in older white women, the latest evidence also shows that among women younger than 45, African American women have the highest rate of breast cancer.
Once diagnosed, they also have the highest death rate from the disease, in part because cancers in younger women tend to be caught at a later stage and seem to be a more aggressive form. From 1973 to 1996, the incidence rate for breast cancer rose 25.3 percent in white women. In African America women the rate rose 36.7 percent.
Death rates from breast cancer are reported to be falling in the United States overall. For black women, however, the picture is less positive: From 1992 to 1996, mortality dropped 5.5 percent in white women while edging higher, up 0.4 percent, for black women.
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Ligala Manns, an African American resident of San Francisco and a 34-year-old mother of two, lost much of her family to cancer during the past decade, and is trying to figure out why much of the community not demanding better from the medical system ... or even taking advantage of what preventive health measures are available.
Her own mother succumbed to breast cancer at age 56 last May; her sister also died of breast cancer in October, 1993. Lung cancer took her father in the spring of 1990. She recalls one of her grandmothers also died of breast cancer many years before. Manns has had no sign of the illness, but gets screened regularly and can only hope the tests keep coming up negative.
Although there is no clear evidence of health problems from the Navy shipyards, she is convinced her mother, who grew up in Hunters Point, was living in "the middle of the toxic zone," a problem that that will be difficult to change for current and future residents.
Lifestyle Problems
"Even if they do clean it up there's a lot of toxins left behind in the soil and the water," she said.
She blamed a rapid decline in the health of her mother and sister on their inability to cope with the trauma of breast cancer and a treatments that included mastectomy, chemotherapy and hair loss.
"It was depression more than anything. You lose your breasts, lose your hair. There are stigmas attached to that, for African American women especially ... They don't seek therapy like white Americans," Manns added, "even though African American women would benefit the most. It's ignorance, really."
Manns said that view may be unpopular, but is convinced that the emotional toll of illness, a lack of education, poor diets and other lifestyle factors are major contributors to the lower survival rates.
But so far efforts to reach out to African American and other minority communities aren't budget priorities.
Next: Funding Crisis
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Breast Cancer: CAUSE & CONTROVERSY by Carl Hall photographs by Pico  SIDEBARS: Photo Gallery: Breast cancer survivors carry on. (Pico) Long Island: A mammoth research effort and its critics. (Hall) Risk factors offer questions and answers. (Wilson)
Toxic Links: How do we know if a chemical is dangerous? (Wilson)
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