Cancer health disparities and risk factors: lessons from a woman with a 20-cm chest wall mass, growing for 2 years

The National Cancer Institute (NCI) has defined cancer health disparities as adverse differences in incidence, prevalence, mortality, survivorship, and burden of cancer or related health conditions that exist among specific populations in the United States. African Americans are more likely than members of any other racial or ethnic population to develop and die from cancer. African American women are more likely than are white women to die of breast cancer, although African American women have a lower incidence rate of this disease than white women. The most conspicuous factors that contribute to the observed disparities are associated with a lack of health care coverage, low socioeconomic status, and race/ethnicity. We recently provided care to a woman who presented to the emergency room with 20-cm chest wall mass. She was found to have inoperable stage IV triple-negative breast cancer with significantly poor prognosis. We describe her presentation, diagnosis, and treatment, identify the factors that contributed to her current condition, discuss the cancer health disparities and the associated risk factors, and reiterate what physicians should know to prevent similar unfortunate and unnecessary scenarios.