Susan G. Komen Issues Report on Breast Cancer in Massachusetts

BOSTON — Despite immense diversity in the Commonwealth, municipalities across Massachusetts experience similar rates of breast cancer. Yet there are clear disparities in death rates based on socioeconomics, race, and education levels. This was one of the key findings in the 2015 “Community Profile of Breast Cancer in Massachusetts,” released this week by Susan G. Komen Southern New England.

Massachusetts is the state with the highest incidence of breast cancer in the U.S., according to national statistics for 2008-12, the most recent five-year statistics available. The incidence-rate trend, how the state ranks year after year, is lower than the national trend. Both death rates and the death-rate trend were lower in Massachusetts than nationwide.

While this data may point to the success of early-detection programs, evidence in the profile suggests that, while Caucasian women are far more likely to be diagnosed with breast cancer, African-American women are more likely to die from breast cancer if diagnosed. These deaths may be related to higher late-stage diagnosis among medically underserved populations.

In medically underserved populations, access to screening and treatment is often hindered by limited transportation options, the need for translation services, inadequate insurance, and the lack of breast-health education. Data showed that women in more affluent towns were found to be better-educated, engaged in better health habits, and had better access to clinical care than their counterparts in less affluent municipalities, leading to different rates of late-stage diagnosis and breast-cancer deaths.

The Community Profile brings together quantitative and qualitative data from various stakeholders, as well as an analysis of current health systems and relevant policies. The information collected provides insight into the actual breast-health needs of women and men throughout the Commonwealth.

“The results of the 2015 Community Profile reinforce what we already know: while much progress has been made in the fight against breast cancer, we are leaving certain populations behind,” said Lori van Dam, CEO of Komen Southern New England. “We’ll use the data in this report to guide our funding, helping women overcome barriers to early detection and making sure that all women have access to the care they need.”

In 2015, there were 25,434 incidences of breast cancer reported in Massachusetts. The cities of Boston, Springfield, and Worcester had the greatest burden from breast cancer. An inventory of breast-cancer services in these cities found approximately 100 providers that offer preventive breast-cancer care and treatment services, including early-detection education, breast-cancer screenings, and genetic-counseling services. Yet, significant differences existed in how these services are delivered. For example, in Boston, patient navigators are available at the earliest stage of care, offering education and connecting patients to early-detection screenings. In Worcester and Springfield, navigation services are provided to patients only after an abnormal finding or diagnosis of breast cancer.

Costs associated with care also differ. In Springfield, the cost for a mammogram averages $320. In Worcester, the same screening ranges from $300 to $490, and in Boston, the range is $300 to $600. In addition, Boston is the only community that offers mobile mammography services. While the Affordable Care Act offers options to obtain healthcare coverage, individuals statewide are still faced with the burden of covering co-payments and high deductibles for services.

Data for the Community Profile was obtained from the Massachusetts Cancer Registry and the state Department of Public Health. Data for all 351 municipalities in the Commonwealth were analyzed in terms of early-stage and late-stage diagnosis, total incidence, late-stage incidence, and death rates. The full Community Profile can be found online at komensouthernnewengland.org.