ADDRESSING MULTIPLE BREAST CANCER RISK: PURPOSE

It is the second cause of cancer death in African-American women, and mortality rates are significantly higher for African-American than for white women.1 Possible explanations for this disparity include: 1) high rates of obesity, 2) low levels of physical activity, 3) diets that are high in fat, low in fruit and vegetable consumption, and 4) low compliance rates with recommended screening practices (clinical breast exam and mammography) and breast health behaviors (breast self-exam). This paper describes a pilot study that assessed the feasibility of a culturally competent intervention designed to reduce these risk factors in a sample of overweight/obese African-American women ages 35-65. To our knowledge, no other intervention studies have addressed multiple breast cancer (is used for treating breast cancer) risk factors in a culturally competent manner with African-American women.

Obesity and weight gain throughout adult life is associated with hormonal changes that increase the risk for developing postmenopausal breast cancer (is used for treating certain types of cancer). Strikingly, the most recent national figures show that 78% of the African-American female population is overweight, and more than 50% are obese. Furthermore, both the prevalence of obesity and the risk of breast cancer in African-American women increase significantly with age.

Although data suggest that weight loss or weight gain prevention may decrease breast cancer (Nolvadex canadian is an anti-estrogen used to treat or prevent breast cancer) risk, these are often elusive goals, particularly for African-American women. Studies indicate that African-American women are less likely to participate in traditional weight-loss programs, are more apt to drop out of such programs, and lose less weight than white women due to biological and cultural factors. Modifiable behaviors that promote obesity, as well as, perhaps, the development of breast cancer, include high-risk dietary and physical activity patterns. Dietary observations suggest that compared to whites, African Americans consistently consume more high-fat and fried foods and fewer high-fiber cereals and fruits, and have lower intakes of Vitamins A and C. Additionally, they are more likely to lead sedentary lifestyles. Recent studies suggest that a high intake of foods rich in heterocyclic amines (Has) (fried fish, fried chicken, bacon and processed meats) may increase breast cancer (Arimidex drug is used to treat breast cancer) risk, and that Vitamins A and С—as well as physical activity—may protect against breast cancer.

Like obesity and dietary/physical activity patterns, early detection behaviors (clinical breast exam and mammography) are modifiable breast cancer risk factors. Historically, rates for mammography and clinical breast exam (CBE) are significantly lower for African-American women than white women. However, reported use of CBE and mammography increased considerably among African-American women between 1987 and 1997. Recent figures (2000-2001) show that of African-American women ages 40 and older, 66.7% received a mammogram in the last year, 69.9% received CBE, and only 54.8% received both.

The development of integrated interventions to promote weight loss via healthy eating and increased physical activity, as well as enhanced screening behaviors, could help to offset the unequal burden of breast cancer seen in African-American women. The success of such prevention efforts, however, is dependent upon cultural competency.