Ask the Expert: Does Breast Cancer Care Vary Based on Race?

This article is part of Breast Cancer and Black Women, a destination in our Health Divide series.

Dr. Doru Paul Ask the Expert

Design by Julie Bang / Verywell

Two people experiencing the same stage of breast cancer may have very different treatment opportunities that are largely dependent on cancer stage at the time of diagnosis and a person’s access to care.

According to Doru Paul, M.D., Ph.D., an oncologist who focuses on individualizing care and improving the prognosis of cancer treatments, there should be no difference in breast cancer care tied to a patient’s race.

But health disparities related to location and income mean cancer diagnosis and successful treatment are not equal across racial lines. Studies have found that Black cisgender women are more likely to die from breast cancer than White cisgender women, despite White cis women being more likely to develop the disease.

Below, Paul explains his experience with reaching underserved cancer patients, as well as what would make the biggest difference in leveling the playing field.

Verywell Health: In your experience, how much does the quality of cancer treatment impact patient outcomes?

Dr. Paul: It is not so much about the quality of the treatment, but it’s about what type of treatments are available when the cancer is detected. Early in the game, cancer can be cured. Later in the game, treatment may lead to fewer cures.

I’ve been working for 10 years in the South Bronx, arguably the poorest area in New York, at Lincoln Hospital. I serve people in underserved areas who are primarily Latino and African American. One of the challenges my patients face is overcoming the fear of going to the doctor and having a screening. For whatever reason, patients come in, receive some treatment, and disappear. That’s especially true for patients that have more advanced disease.

Verywell Health: What are some reasons patients discontinue treatment?

Dr. Paul: For some people, the reason is related to the fact that they needed to work in order to pay their bills. Basically, they think they’re feeling better and they go back to work.

In the South Bronx, I treated a lot of people from large Latino families. And if the patient had to go to work to support a family, they had to go to work. This was not good, but this was the reality.

Still, this is really variable. It doesn’t mean that if you have money, you’re definitely going to be more health smart or aware.

Verywell Health: Are there financial barriers to breast cancer screening and treatment?

Dr. Paul: In New York, the screening is free, so there should be absolutely no financial constraints. But it’s important to know that it is free. Knowledge is extremely important in this context: the knowledge that people can go and have themselves taken care of. There are programs for free mammograms and free Pap smears in some underserved areas.

Verywell Health: How can providers help educate patients?

Dr. Paul: It’s important to help people know what’s going on: give talks in the community, in the churches, etc. It’s important for patients to have access to knowledge and know that doctors are on the same side as the patient. The goal of doctors and patients is the same: a better quality of life. Always remember that doctors can help and provide support.

Also, it’s very important to understand that early detection is the key. The earlier the cancer is detected, the easier the treatment can be.

Communication is fundamental. It’s like the note in the subway: “If you see something, say something.” People shouldn’t assume that what’s going on with their bodies is normal. Always talk to health providers, like doctors, for expert answers.

1 Source
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  1. American Cancer Society. Breast cancer facts & figures 2022-2024.