Disparities in Breast Cancer Care, Genomic Insights and Early Detection

Dr. Regina Hampton discusses the 40% higher breast cancer mortality rate in Black women, highlighting the FLEX study's role in improving early detection and personalized treatment.

Black women face a 40% higher mortality rate from breast cancer compared with other groups, according to the Breast Cancer Research Foundation, highlighting a disparity in detection, treatment and outcomes. To address this unmet need in patient care, Dr. Regina Hampton sat down for an interview with CURE to discuss the importance of tailored screening guidelines and early detection. 

One such study aiming to address this unmet need is the FLEX Study which serves as the largest prospective cohort study of Black women with whole genome and clinical data. Investigators aim to better understand gene expression differences and refine personalized treatment strategies, addressing the biological factors that contribute to higher mortality rates in black women with breast cancer.

In the interview, she discussed the importance of unmet needs in black women with breast cancer, as well as highlights the details of the FLEX study and how genomic information can drive more effective treatment options for patients. Hampton is a breast surgeon and the chief of Breast Surgery at Doctors Community Medical Center, in Lanham, Maryland, which is part of Luminous Health.

CURE: Black women face a 40 % higher mortality rate from breast cancer compared to other groups. In your experience, what are the key factors contributing to this disparity, and how can healthcare systems address these challenges?

Hampton: Black women that develop breast cancer tend to be pretty unique in that they [typically] develop breast cancer at younger ages, oftentimes under the age of 50, when in the general population, we often see it over the age of 60. When these women are young, and especially if they're under the age of 40, it presents a challenge because they're not at the age when we would recommend getting mammograms. We usually recommend getting mammograms starting at age 40.

A young woman who's in her 30s who comes in with a breast mass and is African American, oftentimes many providers say, “You're not 40. You don't need a mammogram. Come back at 40.” [This is an unmet need because we then] are missing a lot of breast cancers. One of the challenges is that not enough people, patients and providers understand the uniqueness of African American women [presenting] at a younger [age], so we can't miss that opportunity.

There have been some who've advocated that we should look at doing more population-specific screening guidelines so that we can hopefully catch more of these breast cancers. I think the other thing is, as we see in other disease states, many times African American patients are not seen or heard when they do have complaints. I think it's been well covered throughout the media about different biases.

[Many times] it is a lot of miseducation and people not understanding or taking the time to see and hear [their] patient, which is a whole other part of the medical system that I think we're all really struggling with.

What strategies have you implemented to improve early detection and access to personalized treatment for African American women?

I think it starts with educating. Educating African American women about their risk, even if they don't have a family history [is vital], as is educating the medical community. This is that they're just more aware when they see these patients to give a second look or to take a different approach than they would take with, say, the average patient. We have seen that tumors in African American women tend to be more aggressive. It oftentimes takes providers and patients being more proactive to get checked out so that there can be early detection.

Regarding the FLEX study, can you break down the goals of this research?

The FLEX study is an exciting project that is being sponsored by Agendia, running their standard test, which is called the MAMMAPrint and the Blueprint. In addition, they're also doing full genome sequencing of the tumor. This is exciting because when you think about what we've done we've moved to looking at more of the genes in people and the human genome and finding out a lot more information. What the FLEX study is doing is saying, “Let's look at the tumor like we look at people. Let's look at all the genes that are in the tumors and get that valuable information and see if that can help us in the future to find why different populations have certain types of tumors and why certain tumors may be more aggressive.” With this data, hopefully this can lead to more exciting treatments that are available for all patients.

Transcript has been edited for clarity and conciseness

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