Breast Cancer Disparities in African American Women: Does Race or Place Matter?

African American women are 42% more likely to die from breast cancer than their White counterparts. The purpose of this phenomenological study was to understand the lived experience of African American, female, survivors of triple negative breast cancer (TNBC) to determine if any of the key tenets of the social determinants of health, particularly race and place/social conditions, influenced their screening through treatment decisions or care. Through the interpretive description approach, six interviews were conducted with survivors of TNBC who either worked or resided in one of eight Monroe County zip codes: 14605, 14606, 14608, 14609, 14611, 14613, 14619, and 14621. These zip codes, home to 63% of the regions African American population, were selected because they had the highest rates of poverty, the worst health outcomes, and the lowest life expectancy of any other zip code in the nine county Finger Lakes region. The findings of this study revealed that the women did not believe their screening through treatment options were influenced by their race or place/social conditions. The following themes were identified: (a) the strength and resilience of the survivors was expressed through their faith and positive attitudes; (b) the importance of physician / patient relationships, including the dissemination of information and patient invalidation; (c) the need for self-advocacy; and (d) the role of support groups. Recommendations for future studies include suggested actions for researchers, physicians and patients to include: using measures of protective factors in research studies; training medical professionals in areas of cultural humility, implicit bias, and structural racism; and, encouraging women to be vulnerable and accept help