A discriminating disease

September 29, 2011 at 12:00a.m.

Breast cancer unites women of all color and creed under a common banner of hope. But not all breasts are created equal. Different minority populations, as well as subgroups within those populations, face distinct challenges and risk factors.

African-Americans

Though Caucasians have the highest incidence of breast cancer overall, African-American women have the highest rates of pre-menopausal breast cancer and are more likely to die from the disease at any age. Socioeconomic status and inadequate access to quality health care are partly to blame for higher morbidity among black women, but genes also play an important role, especially in the younger set.

Asians and Pacific Islanders

At the other end of the spectrum, Asian and Pacific Islander women have the lowest rates of breast cancer and morbidity of all the ethnic groups in the U.S. But those statistics are dangerously misleading because they can give Asian women a false sense of security.

Latinas

For Latinas, their lower rate of breast cancer incidence and mortality could be due to earlier age of first pregnancy and greater likelihood of breast-feeding, plus less use of post-menopausal hormone drugs. But Latinas are more likely than non-Hispanic whites to be diagnosed at a younger age and with worse tumors.

Lesbians

Lesbians are another subgroup with higher-than-average risk factors. Research has shown lesbians are less likely than heterosexual women to seek routine health care, perhaps because they lack insurance or feel discomfort discussing their lifestyle with doctors. They also may be less likely to give birth before age 30, which can contribute to risk.