Breast cancer deadlier for Black women. Study of mammograms could help close gap
Are 3D mammograms better than standard 2D imaging for catching advanced cancers? A clinical trial is recruiting thousands of volunteers — including a large number of Black women who face disparities in breast cancer death rates — to try to find out. People like Carole Stovall, a psychologist in Washington, D.C., have signed up for the study to help answer the question. “We all need a mammogram anyway, so why not do it with a study that allows the scientists to understand more and move closer to finding better treatments and ways of maybe even preventing it?” Stovall said. The underrepresentation of women and minorities in research is a long-simmering issue affecting health problems including Alzheimer’s disease, stroke and COVID-19. Trials without diversity lead to gaps in understanding of how new treatments work for all people. “Until we get more Black women into clinical trials, we can’t change the science. And we need better science for Black bodies,” said Ricki Fairley, a breast cancer survivor and advocate who is working on the issue. Black women are 40% more likely to die from breast cancer than white women and tend to be diagnosed younger. But it’s not clear whether 3D mammography is better for them, said Dr. Worta McCaskill-Stevens of the National Cancer Institute. “Are there populations for whom this might be important to have early diagnosis?” asked McCaskill-Stevens. “Or is it harmful,” causing too many false alarms or unneeded follow-up tests and treatments? McCaskill-Stevens, who is Black, leads NCI’s efforts to boost access to cancer research in minority and rural communities. She has joined the study herself. The newer 3D technique has been around for a decade, but there’s never been conclusive evidence that it’s better than 2D at detecting advanced cancers. The screening technique combines multiple pictures of the breast taken from different angles to create a 3D-like image. Both 3D and 2D mammograms compress the breast and use low doses of radiation. Prior studies suggest that 3D finds more cancers than 2D, but catching more cancers doesn’t necessarily mean more lives saved. Some cancers missed by standard screening may not progress or need treatment. Previous studies did not randomly assign patients to a screening method, the gold standard for research. The notion “that if it’s new, it’s shiny, then it’s better,” isn’t necessarily true, McCaskill-Stevens said. “Until we have the evidence to support that, then we need well-designed
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