When looking into treatment for breast cancer, the options can be overwhelming. Living Well spoke with breast cancer surgical oncologist Erica N. Proctor, M.D., to get a better understanding of the disease and the process of treatment and the research to find a cure.
Dr. Proctor joined the comprehensive medical team at Josephine Ford Cancer Institute at Henry Ford Hospital in Detroit. Previously, she worked for the University of Michigan Health System and began work at Henry Ford in September. She performs breast surgery at Henry Ford Hospital, and sees patients in clinic each week at Henry Ford Medical Center- New Center One in Detroit and Henry Ford Medical Center- Fairlane in Dearborn.
Dr. Proctor also serves as the director of the Breast Cancer Disparities Research, focusing on opportunities to improve access to screening and treatment to improve breast cancer health outcomes in southeastern Michigan. In particular she focuses on the breast cancer disparity rate and mortality rate in African American women and women of any underrepresented minority group. She said, African American “have a higher mortality from breast cancer than white American women.”
There are several factors to explain why underrepresented minorities suffer more, including socioeconomic factors. These factors impact access to healthcare, poverty, and insurance status. African Americans are more likely to be uninsured in comparison to White Americans, making it more difficult to access the healthcare system. These factors create barriers to annual mammogram screening and clinical care, delaying early detection and treatment, leading to a higher mortality rate.
In addition to the socioeconomic factors, African American women are typically diagnosed with more aggressive breast cancer tumors. Dr. Proctor’s research in Africa was primarily driven to find links between African ancestry and more biological aggressive disease. Dr. Proctor travels to Ghana each year to continue work on this research project. African Americans have a much higher chance of being diagnosed with biological aggressive disease, which is breast cancer that is negative for the hormone receptors and negative for her2 neu, also known as triple negative breast cancer.
The warning signs of breast cancer include:
- A lump or a hard mass inside the breast or the underarm area,
- Swelling, warmth, redness, darkening, a change of size of one breast to the other
- Dimpling or puckering of the skin,
- Itchy rash or sore around the nipple of the breast
If you experience any of these signs, you should seek medical attention immediately.
Breast cancer can spread to other parts of the body, typically to the lymph nodes in the underarm area and is usually checked by a biopsy. A biopsy is when a physician takes a sample of the tissue and runs a test to see if it is positive for cancer. Other organs that are affected by the spread of breast cancer are the lung, liver, bone or brain.
Screenings such as mammograms and clinical breast exams are very important in the early detection of breast cancer. Dr. Proctors says, “When breast cancer is found early, it gives the best treatment options and better outcomes for our patients.” High-risk patients are women who have two or more breast cancer relatives, a relative diagnosed with ovarian cancer or a “first-degree relative”, such as a mother or sister who was diagnosed with breast cancer at the age of 40 or younger. Those who are not high- risk should start having clinical breast exams at the age of 20 and every three years after, self- breast exams monthly and annual mammograms at 40 years old.
In the United States, White American women are diagnosed at higher rates than African American women, but the mortality rate is much higher in African American women and diagnosed with breast cancer at an earlier age.
What is being done to narrow the gap of mortality among African American women? The reform of healthcare is improving access to screenings, increasing early detection in African American women. In addition, researchers, such as Dr. Proctor are looking at factors of biological aggressive disease to target for new medication. These drugs would help narrow the gap between women who are not diagnosed with aggressive breast cancer and those who are, typically African American women.
For more information about the care provided by the Josephine Ford Cancer Institute or to schedule an appointment, visit www. HenryFord.com/Cancer.