by Dr. Ada Fisher

Too close to home is all I think of in learning of the death of another one of my nearest and dearest friends from breast cancer this morning. The latest victim entered the hospital in July and is dead today less than six weeks from initial presentation. Of the six of us who hung together in high school and for class reunions, three are dead of breast cancer.

When I completed medical school in 1975, the explosion in numbers for breast cancer had not reached one in ten women as it does today; nor were we doing hormonal, DNA and other tumor type testing to better specify the type of cancer to match it with appropriate treatments. The misnomer for those looking for a cancer cure is that cancer is one disease which it is not. Cancer expresses itself in hundreds of different types, each treated differently.

Breast cancer is the leading killer of women, especially for blacks who interestingly have a lower incidence of the disease but a higher death rate from it. Sadly for African American women, we are more likely to have the disease before 50 which may make it more treatable with hormones. 33.5/100,000 black women die of breast cancer versus 25/100,000 white women bearing the same burden. This health care disparity is related to factors still being studied including genetics, socio-economic status, etc. The bottom line is early detection with self exams and mammograms correlates with a better outcome.

All of that being said, we need to “get real” about Triple Negative Breast Cancer which has a higher incidence in women of color with an unfortunate five year survival of only 14% for African Americans so affected. So what is Triple Negative Breast Cancer? This aggressive tumor does not have markers for hormones progesterone (PR) and estrogen (ES) nor Her2/neu and is considered a subgroup of “basal type” breast cancers. If diagnosed at later stages as is often the case, it is more likely to metastasize (spread) and recur. Mastectomies are frequently not indicated. It may be responsive to chemotherapy but not receptor targeted interventions (for the other three types).

Health Care Reform legislation doesn’t say how this and things that need to be done to help breast cancer victims will be carried out and paid for. Women need to have routine breast screening exams particularly those with family histories of the disease and those of color. Get over our hang ups with the “Tuskegee Experiment,” Triple Negative victims, especially those of color, need to volunteer for drug test protocols so that we can find things that will work. Catastrophic Disease Relief Funds need to be established in each state so that financial ruin may be avoided and duplicated foundations can consolidate resources with minimal overhead.

Women need to be proactive and give more to the Triple Negative Foundation or Susan G. Komen Foundation. If each woman over 21 (approximately fifty million women are in this category) gave $100 that would give us at least five billion for research. It’s about us and we need to invest in ourselves and in our lives.

Dr. Ada M. Fisher is NC Republican national Committee Woman. Contact her at P. O. Box 777; Salisbury, NC 28145; telephone (704) 223-2321. DrFisher@Fishernchousedistrict77.com.