"Black Women are 40% More Likely to Die from Breast Cancer than White Women." - Susan G. Komen

 

That's a statement that would make any woman of color pay 100% attention to.  Are women of color paying attention? I am.  I'm a woman of color. ​

Do women from diverse backgrounds "carry" the cancer cells differently?  Why is the likely mortality percentage number at 40% for Black Women?  These are questions we need to get answers for.  

 

Phenom Magazine will dedicate the entire month of October presenting critical information about  breast cancer. The plethora of information on breast cancer across the world wide web can be overwhelming; so we decided to lay out the facts on breast cancer in a more comprehensive and simple format.  All Phenom Magazine's media platforms will display facts and info about the disease.

 

Phenom Magazine will collaborate with Lisa Whitty Bradley, M.D., FACS  who will be assisting in providing crucial information from credible online sources which answered questions and cleared up some of the myths surrounding breast cancer.  In addition, we shed light on the troubling mortality statistics related to Black Women and the disease.   But first, let's meet Dr. Lisa Whitty Bradley.

​Dr. Lisa Whitty Bradley is CEO & Founder of Loop Plastic Surgery, S.C. and Chicks with MDs, LLC. Both entities focus on the education and empowerment of Patients, Physicians and the community at large. 

 

She is a board-certified Plastic and Reconstructive Surgeon, with additional expertise in the Essentials of Private Practice Building and Restructuring, Social Media Strategy for Physicians, Contract Negotiation, Mastering the Evolution of Healthcare Reform, Self-Advocacy and Care, as well as Disability and Malpractice coverage concerning physicians. 

 

Dr. Whitty Bradley spends a significant amount of her practice time teaching young, as well as, seasoned physicians about the essentials of creating a legally and financially secure practice environment.

 

Born and raised in Flatbush, Brooklyn, New York, she graduated from John Dewey High School and later attended Temple University in Philadelphia, Pennsylvania, obtaining a B.A. in African American Studies. Her travels led to Detroit, Michigan, where she earned her M.D. degree at Wayne State University. 

Dr. Whitty Bradley completed her General Surgery training at the University of Illinois in Peoria, Illinois, followed by a Hand Surgery Fellowship at the University of Connecticut in Hartford. She completed her Plastic Surgery training at the Prestigious Mayo Clinic in Rochester, Minnesota. Her first four and a half years of practice were spent in a multispecialty surgical group; however, she now has a solo practice in Chicago, Illinois.

 

Her passions are family, cooking, writing (under the Pseudonym and Best-Selling Series by Stella Jones) and yoga. Most days you can find her hanging out with her husband, daughter and fur-baby or trying to find the best food spot in town.

 

Lisa Whitty Bradley, M.D. FACS                

CEO & Founder

Chicks With MDs, LLC

WWW.CHICKSWITHMDS.COM

@chickswithmds 

Why are Black Women dying from Breast Cancer at an alarming rate, more than every other racial/ethnic group in the U.S.A?

  • Higher Risk of Triple Negative Breast Cancer, which is diagnosed at an earlier age, more difficult to treat because it does not respond to the major drugs currently on the market and has a higher recurrence (cancer comes back after treatment) and mortality (dying as a result of specific illness/disease) rate.

  • Lack of access to screening studies (mammogram).  Transportation, lack of screening centers in local community.

  • Lack of education regarding the importance of early screening and detection and self- breast exam.

  • Implicit Bias in Health Care that does not address the impact of providers, facilities and providing adequate access, guidance, education and treatment.

  • Lack of insurance.

  • High rate of obesity (fat converts to estrogen, which increases risk of breast cancer).

What are the risks for developing (being diagnosed with) breast cancer?

 

  • Personal History of Breast cancer

  • Being a woman.

  • Family history of breast cancer in 'primary relatives' (Sister, Mother, Daughter).

  • Radiation to the chest wall as a child (usually radiation as a child for cancer).

  • Obesity.

  • Early onset of menses (period), before age 12 and late menopause-longer exposure to estrogen, after age 55.

  • Genetic Mutations (Breast Cancer Gene)-BRCA1 and BRCA2.

  • Dense breasts- more connective tissues than fat, which makes it more difficult to detect suspicious lesions on mammogram.

  • History of 'high risk' non'cancerous lesions, such as atypical hyperplasia or lobular carcinoma in-situ.

  • Sedentary-not being physicially active.

  • History of hormonal therapy-hormone replacement therapy (Estrogen and Progesterone) and oral contraceptives (birth control pills).

  • Having first child after age 30.

  • Never having a full term pregnancy.

  • Not breastfeeding.

  • Drinking alcohol.

  • Women who took the drug (DES) diethylstilbestrol, 1940-1971, to prevent miscarriages, or whose mother took the drug while pregnant.

What is Triple Negative Breast Cancer?

​​

  • Every cancer cell has receptors (places that can accept hormones and other molecules that can affect how the cancer responds to stress and medications).  Drugs have been developed that can sit in those receptors and stop factors (ex. Estrogen and Progesterone) that would otherwise help the cancer grow.  When the receptor is there and the drug stops anything from activating it, the cancer cannot grow!!!

What types of receptors are targeted by medications?

 

  • Estrogen, Progesterone and HER2 Neu.

Are there breast cancers that do not have these receptors? 

 

  • Yes.

What are those cancers called? 

 

Triple Negative Breast Cancer.

  • ER (Estrogen Receptor) negative, PR (Progesterone Receptor) negative and HER 2 Receptor Negative.  These are the receptors (sites) targeted on cancer cells by medications used to treat/prevent recurrence of breast cancer.  Ex. Tamoxifen and Herceptin

Are there certain groups of women who are more at risk for developing Triple Negative Breast Cancer? 

 

  • Yes.

      

Who? 

 

  • Young Women: Age 40-50. BRCA1 Cancer Gene. Black Women.  Women of African Descent are 3X more likely to be Diagnosed with Triple Negative Breast Cancer (TNBC) compared to White or Hispanic women.

      

Why?

  • African Ancestry.  Obesity. Lower Rates of Breastfeeding.

​Does Diet and Weight (Obesity) put me at risk for breast cancer?

  • Post-menopausal women who are Overweight or Obese (BMI 30 or greater) have a 30-60% higher risk of developing breast cancer compared to their 'leaner' counterparts.

What percentage of the U.S. female population will develop Breast Cancer over their lifetime?

  • 12%, 1 in 9, of women in the U.S. will be diagnosed with Breast Cancer

Is there a disparity between the survival and recurrence rate of Black women diagnosed with Breast cancer vs. White Women?

  • Yes

 

Why? 

  • Delayed Diagnosis.  Inadequate access to Breast cancer screening centers and breast cancer care specialists (Oncologists, Surgeons, Mammography Centers). 

  • Lack of insurance.  Lack of education regarding breast health.  Implicit Bias in healthcare. 

  • Higher rate of diagnosis of Triple Negative Breast Cancer, which is more aggressive, harder to treat, has a rate of recurrence (breast cancer coming back after surgery/medical treatment) and lower survival rate. Black women are more likely to be diagnosed with 'advanced' stage Breast Cancer (involving lymph nodes or has spread to other parts of the body). 

  • Lower breastfeeding rate-Breastfeeding is protective AGAINST developing breast cancer.  High rate of obesity, which for post-menopausal women increases the risk of developing breast cancer.

  • The mortality (death) rate from Breast cancer for Black Women is 41% higher compared to White Women.

Can Breast Cancer Be Inherited? 

 

Yes.  However, the overwhelming majority of breast cancers diagnosed do not have an identifiable inherited genetic mutation.

 

What percent of Breast Cancer is inherited?

​​

  • 5-10% of all Breast Cancers are secondary to gene mutations involving BRCA1 or BRCA2.

  • Patients with BRCA1 gene have a 55-65% chance of being diagnosed with Breast cancer by age 7.0

  • Patients with BRCA2 gene have a 45% chance of being diagnosed with Breast cancer by age 70.

 

So if most breast cancers are not 'inherited' why are the cancer genes (BRCA1 and BRCA2) a big deal?

  • Great question!  Because those who have BRCA1 and/or BRCA2 have a much higher risk of developing  breast cancer and/or ovaria cancer, and therefore need closer surveillance (Mammogram, MRI, Ultrasound, etc..., as directed by their physician/health care provider).

At what age should I start performing self-breast exams? 

 

  • Age 20 is the general recommended age, however lumps and breast problems can develop AT ANY AGE, so please get in the habit of examining your body and becoming an advocate for your health, as soon as possible!!!

 

What time of the month should I perform my self-breast exam? 

  • Breast exams should be performed when the breasts are not painful or swollen.  For women who are still menstruating (period) this is usually 7 days after the onset of your period.  For women who have gone through menopause, figure out what day of the month is best suitable to perform your breast exam.

  • **As Always, Talk with Your Physician/HCP to Formulate a Plan that Works for YOU!!!**

What are tips for my self-breast exam? 

  • The breast exam is VISUAL and PHYSICAL.

  • Start with inspecting your breasts, chest, arms and torso in the mirror.  

  • Inspect your breast with your hands at your sides and on your hips.

  • Look for changes in skin color, dimpling, thickening (orange peel appearance), change in nipple position/appearance, nipple discharge or anything that looks different compared to YOUR normal.

  • Perform your breast exam standing up-the shower with warm hands, water and soap really help in terms of examining the breasts and finding small lumps/bumps that may be difficult to feel.

  • Also examine your breast while laying flat on your back.  There are some lumps/bumps that can be missed when you are standing!!!!

  • Use the tips of your fingers (Index, middle and ring) and start from the outer aspects of your breast (as far out as your armpit and then use a circular motion to move around the breast and inward to the nipple).  

  • DON'T FORGET the breast tissue along your chest wall, leading to your armpit!!!

  • THE MAJORITY of breast cancers are found in the UPPER OUTER QUADRANT of the the breast (near the armpit!!!!).

  • Always examine your nipple and areola (pigmented skin around the nipple)/

Are mammograms effective at detecting Breast cancer?

  • Yes.  Pre-cancer and Cancerous lesions can be detected at an earlier stage, which can lead to increase survival, decrease recurrence and lower staging at the time of diagnosis.

Can Mammograms miss some cancers?

  • Yes.  There are some lesions that are too small or that do not exhibit the characteristic of a typical cancer (Ex. Calcifications).

 

When should I get my first screening mammogram?

  • General Population-Annual Screening Mammogram beginning at AGE 40 until at least age 74.

  • If you have a personal, strong family history or known inherited genetic mutations (BRCA1 and/or BRCA2) your screening schedule may be different. 

  • Another reason why it is ESSENTIAL that you see your doctor/HCP routinely and provide a complete personal and family history regarding any and ALL medical diagnoses, including CANCER.

Do Mammograms cause Breast cancer or injure the breast? 

  • Mammograms do not CAUSE breast cancer.  Any procedure has the risk of causing injury, however the risk of causing trauma (bruising, bleeding and/or chronic pain) is extremely low.

Do Mammograms prevent Breast cancer?

  • No.  The point of mammograms is for detection of cancer and pre-cancerous lesions and/or follow up for previous breast lesion treatment or cancer therapy.

What if I feel a lump?

  • Contact your physician/health care provider right away and relay the location of the lump, how long it has been there and any associated pain, drainage, change in your skin or anything else that was noticed along with the mass.

 

What if I have nipple discharge?

  • Notify your physician/health care provider right away

  • Relay the color, odor, quality of the drainage (watery, bloody, mucus, thick, thin, color, spontaneous, associated with erotic stimulus, recent history of breast feeding, etc.)

Can I Still Get a Mammogram if I am Uninsured or cannot afford the co-pay?

 

  • Please check out the websites below for a list of nationwide resources that will help you find low cost/free breast exams and mammograms:

 

 

 

  • ***If you’re 40 or older, the Affordable Care Act requires your insurer to cover screening mammograms with no co-payment***

 

  • If you have MEDICARE or MEDICAID, your assigned representative and/or physician/health care provider should be able to help you locate a breast center in your area that provides screening mammograms to women 40 years of age and older.

 

  • If you have a family or personal history of breast cancer, talk with your physician/health care provider and find out the right screening/follow up study for you.

What can WE do to break the cycle that puts Black women at higher risk of being diagnosed with advanced stage (cancer is diagnosed with large, outside of the breast, growing in lymph nodes and/or metastasized (spread) to bone, brain and other parts of the body)?

  • Schedule a general physical exam with your physician/health care provider.

  • Perform monthly breast exam.

  • Annual mammogram for ALL women starting at age 40…or as directed by your physician/HCP, if you have a family or personal history of breast cancer.

  • If you have no insurance, high out-of-pocket costs or your breast care/cancer centers are far from you, please contact @plannedparenthood for information and assistance.  Also contact @susangkomen for info on free/low cost mammograms.

  • Ask your family members about any history of ANY type of cancer.

I choose to live

What is DCIS (Ductal carcinoma in situ) Stage 0 breast cancer?

  • Ductal carcinoma in situ (DCIS) is a very early non-invasive cancer that is treatable. Cancer cells are contained in the milk ducts and have not spread to the surrounding breast tissue or distant sites. 

  • It is estimated that only about 20-30% of DCIS patients go on to develop invasive breast cancer.

  • After a diagnosis of DCIS, the first step is usually surgery to remove the DCIS tumor. The next step is to determine the risk that your breast cancer will return in the same breast (called local recurrence), either as DCIS or as invasive breast cancer

What is local recurrence cancer?

The reappearance of the cancer in part of the body where it first occurred.

What is invasive breast cancer?

Cancer that has spread from where it started in the breasting surrounding, healthy surrounding tissue.  Most invasive breast cancer starts in the ducts (tubes that carry milk from the lobules to the nipple).  Invasive cancer can spread from other parts of the body through the blood and lymph system.  Invasive cancer is also called infiltrating cancer.

 

What is the treatment for DCIS cancer?

 

Radiation Therapy or Hormone Therapy. There are risks and side effects with both treatments.  Speak to your doctor about which treatment is right for you.

What are the signs of invasive breast cancer?

Breast cancer may have no signs or symptoms, especially during the early stages. As the cancer grows, you may notice one or more of the following:

  • A lump or thickening in or near the breast or in the underarm that continues after your monthly menstrual cycle

  • A mass or lump, which may feel as small as a pea

  • A change in the size, shape, or contour of the breast

  • A blood-stained or clear fluid from the nipple

  • A change in the feel or appearance of the skin on the breast or nipple -- dimpled, puckered, scaly, or inflamed

  • Redness of the skin on the breast or nipple

  • A change in shape or position of the nipple

  • An area that is distinctly different from any other area on either breast

  • A marble-like hardened area under the skin

You may notice changes when you do a monthly breast self-exam. By doing a regular self-check of your breast, you can become familiar with the normal changes in your breasts.

What to expect when someone you know has cancer?

Possible physical changes.  There are some common physical changes shared by many people with cancer. The cancer itself causes some of these changes and others are the result of side effects of cancer treatment. Keep in mind that each cancer journey is different. The person with cancer may or may not have any of the following:

  • Hair loss, including eyebrows and eyelashes

  • Weight loss or weight gain

  • Appetite loss or increase

  • Changes in how things taste or smell

  • Extreme tiredness called fatigue (more information follows)

  • Pale skin and lips, or changes in skin color

  • Disfigurement (for example, the loss of a limb or a breast after cancer surgery)

  • Nausea and vomiting

  • Problems with sleep

  • Poor concentration (sometimes called chemo brain)

How can people who have cancer learn to cope with psychological stress?

Emotional and social support can help patients learn to cope with psychological stress. Such support can reduce levels of depression, anxiety, and disease- and treatment-related symptoms among patients. Approaches can include the following:

  • Training in relaxation, meditation, or stress management

  • Counseling or talk therapy

  • Cancer education sessions

  • Social support in a group setting

  • Medications for depression or anxiety

  • Exercise

The Breast Cancer Myth

  • Drinking milk (or dairy) causes breast cancer.

The Truth

  • Several myths persist about the correlation between dairy intake and the increased risk of breast cancer.  Over many decades, studies have shown that dairy consumption does not increase the risk of breast cancer.  

The Breast Cancer Myth

  • Finding a lump in your breast means you have breast cancer.

The Truth

  • Only a small percentage of breast lumps turn out to be cancer.  But if you discover a persistent lump in your breast or notice any changes in breast tissue, it should never be ignored. It is very important that you see a physician for a clinical breast exam. He or she may possibly order breast imaging studies to determine if this lump is of concern or not.  Take charge of your health by performing routine breast self-exams, establishing ongoing communication with your doctor, getting an annual clinical breast exam, and scheduling your routine screening  mammograms.

The Breast Cancer Myth

Men do not get breast cancer; it affects women only.

The Truth

  • Quite the contrary, each year it is estimated that approximately 2,190 men will be diagnosed with breast cancer and 410 will die. While this percentage is still small, men should also check themselves periodically by doing a breast self-exam while in the shower and reporting any changes to their physicians.  bBreast cancer in men is usually detected as a hard lump underneath the nipple and areola.  Men carry a higher mortality than women do, primarily because awareness among men is less and they are less likely to assume a lump is breast cancer, which can cause a delay in seeking treatment.

The Breast Cancer Myth

Breast cancer is contagious.

The Truth

  • You cannot catch breast cancer or transfer it to someone else's body. Breast cancer is the result of uncontrolled cell growth of mutated cells that begin to spread into other tissues within the breast. However, you can reduce your risk by practicing a healthy lifestyle, being aware of the risk factors, and following an early detection plan so that you will be diagnosed early if breast cancer were to occur.

Do men have breast tissue, and if so, can they also develop breast cancer?

  • Yes, men do have breast tissue.  Yes, men can develop breast cancer.

 

  • 1% of all breast cancer occur in men.

 

  • Men also need to examine their chest walls, nipple/areola and breast tissue.

 

  • Risk Factors: Older age, Exposure to estrogen, Family History of Breast cancer, Obesity,

 

  • Liver Disease, Klinefelter's Syndrome, Radiation Exposure, Testicular disease or surgery.

 

  • The same form of therapy as women is offered, depending on the location, grade and extent of the breast cancer.  Ex. Lumpectomy/Partial mastectomy, lymph node dissection/removal, chemotherapy and/or radiation.

What are my options if I need a mastectomy to treat breast cancer?

  • Do nothing.  Some women chose to have nothing done following treatment for breast cancer.

 

  • Breast prosthetic.  This is when an external device is utilized to assume the shape of a breast underneath clothing.  It is removable.

 

  • Tissue expander/implant reconstruction.  A breast prosthetic device is placed underneath the chest wall tissues during surgery.  The tissues and prosthetic device are contoured to the shape of a breast by a plastic and reconstructive surgeon.  A nipple areolar complex can be constructed utilizing chest wall skin and tattooing, at a later time, if desired by the patient.

 

  • Autologous breast reconstruction. This involves utilizing skin, fat, muscle and blood vessels from other parts of the body (Ex. Latissimus dorsi-back, rectus abdominis-abdominal wall) to recreate the breast.  

What is Chemotherapy?

  • Medicines/Drugs Used to Treat Cancer.

  • Can Be Administered/Given by Mouth (Ex. Tamoxifen), IV(Intravenous), Topical (Applied directly to a site, Ex. such as skin) and even directly into the spinal fluid (IntraThecal)

  • They work by killing cancer cells in your body that grow and multiply much more quickly than most cells in the body.

  • Kills Cancer Cells. Shrinks tumors sot that other treatments, radiation or surgery, are possible. Relieve the signs and symptoms of cancer for patients who are not candidates for curative therapy (Palliative Care).

  • Do All Patients with Cancer Require Chemotherapy? NO.

  • Do All Patients with Breast Cancer Require Chemotherapy? No.  Some patients with 'Non-Invasive' Breast Cancer (DCIS and LCIS) may not require chemotherapy, depending upon the size and extent (how much of the breast tissue is involved) of disease.

Is it Recommended that ALL Patients with Invasive Breast Cancer Receive Chemotherapy?

  • YES. 

  • This includes Stages I, II, III and IV (metastatic disease that has spread to bone, brain, lung and lymph nodes outside of the axilla (armpit).

What are the indications/reasons for Receiving Chemotherapy?

  • To kill microscopic cells that may be left behind after surgery or radiation, in order to reduce the change of recurrence of the breast cancer.

  • To shrink tumors that may make surgery difficult or impossible.

What are Some of the Potential Side Effects of Chemotherapy?

  • Short term: Nausea, Vomiting, Diarrhea, Hair Loss (Alopecia), Loss of Appetite, Fatigue, Fever, Mouth Sores, Pain, Constipation and Bruising.

  • Long term: Damage to Lungs, Heart Problems, Infertility, Kidney (renal) problems, Nerve Damage (Peripheral Neuropathy) and/or Risk of a second cancer.

  • Can You Receive Chemotherapy While You are Pregnant?  Yes.  Depending on the type of cancer and chemotherapy recommended, it is usually safe to receive chemotherapy AFTER the first trimester.

 

***As with all medical therapy, it is ESSENTIAL that you discuss your specific diagnosis and recommended therapy with your PHYSICIAN, SURGEON, ONCOLOGIST and any other Health Care Providers***

What is radiation therapy?

  • High energy X-rays, protons or other particles (cells) that can kill cancer cells.

  • Targets rapidly growing cells, including cancer.

 

When is radiation used to treat breast cancer?

  • 1. After Lumpectomy/Partial Mastectomy to treat remaining tissue and decrease the chance of the cancer coming back (recurrence).

  • 2. Large tumors greater than 5 cm(2 inches).

  • 3. Positive margins- when cancer cells are at, or close to the cut edge of tissue, after the tumor is removed

  • 4. Inflammatory Breast Cancer- Cancer that infiltrates (involves) the overlying skin and surrounding tissues.

  • 5. Large tumors that cannot be surgically removed.

  • 6. Metastatic disease (cancer that grows outside of the breast and axilla/armpit).

 

What type of radiation therapy is available?

 

  • 1. External beam- machine delivers radiation outside of the body

  • 2. Internal radiation/brachytherapy-delivery device is placed near the tumor site/bed for short periods to deliver radiation.

What are some of the side effects of radiation therapy?

  • 1. Fatigue

  • 2. Cough

  • 3. Chest pain

  • 4. Skin irritation- redness, peeling and blistering

  • 5. Breast swelling

  • 6. Change in skin sensation 

  • 7. Lymphedema (arm swelling)

  • 8. Damage to breast implant or tissue surrounding the implant (capsular contracture).

  • 9. Inflamed lung tissue

  • 10. Heart damage

  • 11. Secondary (new) cancers, bone or muscle, or lung cancer

Are you aware that the Affordable Care Act, AKA OBAMACARE, legally mandates that health insurers must cover SCREENING mammograms, every 1-2 years, for women age 40 and older, with no Co pay?

Things you will need:

 

  • 1. Prescription from your physician/health care provider.

.

  • 2. Know what mammography/breast centers are covered under YOUR insurance policy.

  • 3. Whether you require a SCREENING (no symptoms, signs or history of breast cancer or disease) vs. a DIAGNOSTIC (you have signs, symptoms and/or history of breast cancer or disease) mammogram.

  • 4. 3D mammography will likely have out of pocket costs. Talk with your physician/HCP and breast center to find out more.

  • 5. Follow up and GET YOUR RESULTS.

Breast cancer survival is directly correlated to EARLY DETECTION!!! If you do not hear back from the mammography center or your physician/HCP, within 7-10 days, CALL and find out your results!!!

 

***Remember that the law covers you, every 1-2 years, for SCREENING mammograms, with no Co pay, if you are 40 years and older***

***The DIAGNOSTIC mammogram will have out of pocket expense!!!***

 

https://www.webmd.com/health-insurance/free-breast-cancer-screening#1​

https://www.medicare.gov/coverage/mammograms

https://ww5.komen.org/BreastCancer/Mammography.html


Disclaimer: This is informational only. This is not an evaluation, recommendation or diagnosis of your specific health. Contact your physician/HCP for questions and concerns regarding your health.

References:

 

Disclaimer:  This is informational only.  This is not a diagnosis, consultation or recommendations for your specific health.  Contact your physician/health care provider for questions, concerns, diagnosis and treatment for your health.

 

www.cdc.gov

https://www.breastcancer.org/symptoms/testing/types/self_exam

 

https://www.cancer.gov/about-cancer/causes-prevention/genetics

 

https://ww5.komen.org/BreastCancer/BRCA1andBRCA2.html

 

https://ww5.komen.org/BreastCancer/OverweightWeightGain.html

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3603001/

 

https://www.cdc.gov/cancer/dcpc/research/articles/breast_cancer_rates_women.htm

 

https://www.breastcancer.org/research-news/blacks-continue-to-have-lower-survival-rates

 

https://www.breastcancer.org/risk/factors

https://www.mybreastcancertreatment.org

https://www.webmd.com/breast-cancer/guide/invasive-breast-cancer#1

https://www.cancer.org/treatment/understanding-your-diagnosis/talking-about-cancer/when-someone-you-know-has-cancer.html

https://www.cancer.gov/about-cancer/coping/feelings/stress-fact-sheet

https://www.nationalbreastcancer.org/breast-cancer-myths

https://ww5.komen.org/TNBCofAAWomen.html

 

https://www.breastcancer.org/symptoms/diagnosis/trip_neg/who_gets

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5740844/

 

http://www.sistersnetworkinc.org/breastcancerfacts.html

 

https://www.mayoclinic.org/diseases-conditions/male-breast-cancer/symptoms-causes/syc-20374740

 

https://www.nationalbreastcancer.org/male-breast-cancer

 

https://www.kff.org/womens-health-policy/fact-sheet/coverage-of-breast-cancer-screening-and-prevention-services/

https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/chemotherapy.html

 

https://www.mayoclinic.org/tests-procedures/chemotherapy/about/pac-20385033

 

https://www.breastcancer.org/treatment/chemotherapy/who_gets_it

https://www.mayoclinic.org/tests-procedures/radiation-therapy-for-breast-cancer/about/pac-20384940