When Elizabeth Richard was 27 years old, she noticed a painful lump in her breast. Working as a scrub tech at Our Lady of Lourdes Women’s and Children’s Hospital at the time, she reached out to a doctor to have a biopsy taken. At first, the physician was reluctant, but Richard stood firm.
“My doctor stood over me and he had tears running down his face,” Richard remembered the moment she woke up from the surgery. “He said: ‘I’m so glad you were persistent’.”
Roughly 42,000 women and 500 men in the United States die each year from breast cancer, according to the Centers for Disease Control and Prevention. Black women have a higher rate of death from breast cancer than all other women.
At a panel discussion Thursday organized by the New Orleans Musicians Clinic & Assistance Foundation, three women shared their unique breast cancer survival journeys and urged everyone to take preventative measures as early as possible and monitor their bodies closely.
“Know your body,” Richard, one of the panelists, said.
Many insurance plans, however, still do not cover mammograms for patients under 40, something the panelists lamented as a major obstacle in preventing breast cancer deaths.
“I wish insurance was different,” said panelist Yulandera Moody, who noted that access to health care and the insurance to pay for it is one of the major challenges faced especially by Black women. This makes it even more important to advocate for oneself, she added, especially if there’s a history of breast cancer in the family.
“I hope that you have a doctor that would understand, that can approve a mammogram,” she said. “And if you don’t — find yourself another doctor.”
Louisiana has one of the highest breast cancer mortality rates in the nation, and Black women are disproportionately affected. Even as access to health insurance was expanded through the Affordable Care Act, something that was shown to greatly reduce the racial mortality gap in other states, this disparity persisted in Louisiana.
A recent study published in the journal of the American Cancer Society found that the underuse of advanced imaging technology such as breast MRIs likely plays a role in the state. Nationwide studies have found that biology, lifestyle, access to healthcare, institutional biases, a lack of research featuring Black female subjects and distrust in medical institutions and physicians all play a role.
Moody said she found herself doubting her doctor’s approach and wondering whether she was being treated differently as a Black woman, after hearing other cancer survivors’ experiences. “You don’t know this doctor, you’re referred to them,” she recalls her trepidation. “And your life is essentially in their hands.”
Distrust of doctors, most of whom are White, is a common factor in Black women not getting the help they need, she noted. “A lot of it is based on fear and thinking: ‘You know, the doctors are White, they’re not gonna take care of me anyway’.”
Eventually, a conversation with her physician alleviated those concerns for her, Moody said. “As I went through the journey, I saw for myself that it really is different with every single person.”
Moody counted herself lucky to have both health insurance and a job that would allow her the time off she needed to complete treatment. A lack of access to healthcare, she said, often begets other barriers.
“A lot of Black women don’t have jobs that provide an insurance plan. They don’t have access to good health care,” she said. As a result, cancer monitoring isn’t necessarily part of Black women’s health regiment, she added.
“I don’t ever remember growing up hearing my mom talk about going to get a mammogram. I never heard the word until I was an adult. So that’s not instilled in us,” she said.
Richard agreed that awareness is a key part of improving mortality rates in the state, for patients of any race. “More healthcare, more awareness,” Richard said of the solutions to high breast cancer mortality rates. “If you feel something you need to go to someone.”