SEATTLE — Even before her diagnosis, Bridgette Hempstead says her cancer fight was an uphill battle.
“My doctor told me when I requested for a mammogram, she said you don’t need one,” said Hempstead. “because you’re an African American Black woman. Come back in 10 years, it’s something that doesn’t happen in your community.”
Hempstead pushed for one anyway and was diagnosed with breast cancer.
Years later when her cancer metastasized, she says doctors again were dismissive.
“(They) said it’s just a shadow. It’s nothing. Take some cough medicine and don’t worry about it,” said Hempstead.
She believes these incidents highlight how systemic racism could impact a timely cancer diagnosis.
“We know that Black women continue to experience higher breast cancer mortality compared to white women,” said Dr. Marissa Lawson, a radiologist with UW Medicine who recently published a study on race and cancer. “This is despite all of the advances in screening and diagnosis and treatment.”
“We wanted to see if there are racial differences in the time to biopsy, because this could potentially be impacting the breast cancer outcomes we’re seeing in different racial groups,” said Lawson.
The data comes from 45,000 women who received abnormal mammograms and needed to schedule a biopsy.
“So this is where a small sample of whatever abnormal imaging finding was seen, is collected and then sent to our pathology colleagues to look at under a microscope,” Lawson said. “And at that point, we can definitively say if there’s cancer present, or not present.”
It’s that window between mammogram and biopsy where Lawson says the medical community is failing some patients.
“We still saw that patients, Black women and Asian patients, they were experiencing longer delays to biopsy compared to white women,” said Lawson. “And so this is when we have to question, is there a structural racism that’s impacting these delays?”
These delays can be deadly. Without a timely biopsy and diagnosis, a patient’s survival rate decreases.
Lawson’s research shows that Asian women had a 66% higher risk of not getting a biopsy within the first month, compared to white patients. For Black women, the risk was at 52% higher.
Nearly three months in, Black women had a 62% higher risk of not receiving a biopsy.
Researchers took several variables into consideration including a patient’s age, whether they’d had a biopsy before and even a hospital’s resources.
The study found “structural racism, within and beyond health care, may contribute to these differences.”
Lawson says she’s not surprised by this conclusion, but hopes it won’t deter women from getting care.
“Even though there are some structural factors that are contributing to some unequitable outcomes, the research continues to show that when patients come in for their screening mammogram, it continues to improve outcomes,” said Lawson.
Hempstead agrees and says she felt the need to act.
As a result, she founded The Cierra Sisters, an organization providing communities with breast cancer information in the hopes of saving more Black lives, while she fights for her own.
“If your health care provider is not having your health at the best interests, then you have to know what to do,” said Hempstead. “So we’d need to educate our community on what to ask for, what to look for, and how to navigate through a very complex healthcare system that is built on racism.”
Although Hempstead and Lawson have never met, Lawson says organizations like The Cierra Sisters can be vital for helping women navigate their cancer journey.
She also hopes her research will prompt hospitals to prioritize equity in breast cancer scheduling and treatment.
©2022 Cox Media Group