Breast cancer war focuses on blacks

After two mammographies did not detect a malignancy, Carmen K. Johnson learned she had breast cancer in 1999 when she hooked her bra into a lump.

She pressed her doctors for fast treatment, enduring chemotherapy, radiation, breast removal, and breast reconstruction, and she became a survivor.

She also has become an ambassador for the city of Boston's newly relaunched Pink and Black campaign, designed to raise awareness of how breast cancer affects black women. To get the message across, the city has put up posters with the motto "Pink is not the only color associated with breast cancer."

Why the racial focus? According to the Boston Public Health Commission, black women in Boston are more likely than whites to get screened, but black women are more likely to die after diagnosis, due in part to genetic and socioeconomic factors.

Survivors say that until the first half of this decade, pop culture had convinced many people that breast cancer mostly affected white women, and there was little formal support for finding such things as properly colored prosthetics .

"Most of the ads I've seen were always white women, like it's a white woman's disease," said Johnson , who is one of several short-haired, African-American cancer survivors featured in a Pink and Black campaign ad. "It's imperative that black women find their lumps early. The doctors still don't know what causes breast cancer, and they surely don't know why breast cancer in black women is more aggressive."

Boston's numbers reflect national statistics in which 1 in 8 white women will get breast cancer, compared with 1 in 10 black women. However, nearly 90 percent of white women with breast cancer survive beyond five years, while only 75 percent of black women do, researchers say. Young black women also are more likely to develop the sort of tumor that grows fast and does not respond well to treatment.

To address the disparities, the Boston Public Health Commission launched the Pink and Black campaign in October 2005, with Mayor Thomas M. Menino . Several studies have found that many people of color, even if the well-off with excellent healthcare benefits, received a lower level of care as compared with whites.

To counter this, the Centers for Disease Control and Prevention created a coalition designed to help women of color battle inequities in healthcare, a program being replicated by the Boston Public Health Commission

Menino is dedicated to eliminating such disparities, said his spokeswoman, Meaghan Maher .

"Cancer prevention, detection, and treatment are obviously very important to the mayor, so when we see disparities with black women and breast cancer, we as a city have an obligation to try and address that issue," Maher said. The Pink and Black program "is so important because the women have really become ambassadors. They're very inspiring and empowering to other women in Boston."

This year, the campaign adds a website: pinkandblack.org . This is in addition to the city's mobile, and low-cost, mammography van and posters. The ambassadors are talking to church groups and teenagers to remind them that breast cancer does not discriminate and it's never too early to conduct a breast self-examination.

Johnson has started a support group at Morning Star Baptist Church in Mattapan, while the other ambassadors are preparing to make a mini-movie in January, with plans to use mass media to convey their tales to other black women who might not know they are prime cancer targets.

"There is no easy answer to explain the difference in health outcomes for black women suffering from breast cancer," said Nancy Norman , medical director of the Boston Public Health Commission. "What harm is there in trying to expand a breast cancer awareness campaign by pointing out some facts that . . . are enough to catch some people's attention, especially black women ?"

Adrienne P. Samuels can be reached at asamuels@globe.com