Some women, like actress Angelina Jolie, have the surgery after testing positive for the BRCA gene, an inherited gene mutation that indicates a high probability of developing the disease. Others, like Rockeymoore Cummings — who is seeking to succeed her husband, the late congressman Elijah E. Cummings (D-Md.) — tested negative for the BRCA gene but have a strong family history of cancer.
Rockeymoore Cummings, 48, said more research must be done to understand the susceptibility to breast cancer for black women, who die of the disease at significantly higher rates than white women, and to develop more accurate genetic predictors of black women’s risks.
Her mother died of breast cancer in 2015, she said, and her younger sister had a double mastectomy after being diagnosed with breast cancer last year. Neither tested positive for the BRCA mutation. Rockeymoore Cummings also lost a close friend, Katrina Dennis, to the disease this year.
She and her husband decided this summer that she would schedule the surgery; after his death in October, she said, she was as determined as ever to to go through with the procedure.
“I wanted to make sure I was taking the affirmative measures,” Rockeymoore Cummings said in an interview. “It just seems like, what happened with my mother and my sister, I just felt like I was next. And instead of waiting around for it, I just felt like I needed to be proactive.”
Breast cancer is the second-deadliest cancer among black women, according to the American Cancer Society. And while the rate of breast cancer has dropped in the African American community, the death rate from it is 40 percent higher among black women than white women.
The reasons for the racial disparities vary, experts say. White women tend to be diagnosed at an early stage. Black women have a higher rate of obesity, tend to have other chronic illnesses and have less access to quality health care. Black women are also more likely than white women to get triple-negative breast cancer, a version of the diseasethat often is aggressive and comes back after treatment.
While there is no data available on the racial makeup of women undergoing prophylactic mastectomies, experts say they are seeing an overall increase in the surgery as a treatment option. The federal Agency for Healthcare Research and Quality released a study of 13 states in 2016 that found that the rate of preventive double mastectomies doubled — from 2.1 women per 100,000 to 4.4 women per 100,000 — between 2005 and 2013.
Len Lichtenfeld, deputy chief medical officer for the Atlanta-based American Cancer Society, said more women have gotten tested for the BRCA gene since Jolie published an essay in the New York Times about her decision to get a double mastectomy in 2013.
Lichtenfeld said Jolie’s disclosure “did a service to women by bringing [breast cancer] back in the public eye,” much in the same way first lady Betty Ford raised breast cancer awareness when she had a mastectomy in the mid-1970s.
While women of all races and ethnicities are now undergoing the BRCA test to determine if they carry the gene mutation, it is also important for people to remember that “family history matters,” said Susan Domchek, the executive director of the Basser Center for BRCA at Penn Medicine’s Abramson Cancer Center.
“What that threshold should be for when people decide on doing the procedure is very personal,” she said of mastectomies.
Cancer runs deep in the family of Courtney Glass, a 36-year-old attorney from Greenbelt. But she said going ahead with the BRCA test was difficult: “I literally walked around with the paper in my laptop bag every day for almost a year.”
When Glass was in 10th grade, her mother successfully fought breast cancer with radiation treatment and a single mastectomy. Years later, though, Phyllis Glass developed uterine cancer.
She died in February 2011, at the age of 64, seven weeks after Courtney Glass celebrated passing the bar. Glass’s father battled prostate cancer in 2003. He has since been treated for another round of prostate and bladder cancer.
Glass found out she carried the BRCA1 gene in August 2015. She said her doctor told her she had an 87 percent chance of having breast or ovarian cancer. Less than a year later, she had the double mastectomy, which her doctor said reduced her chances of developing breast cancer to 2 or 3 percent.
“I tell everyone: If you have a history of cancer, go get the test done,” she said. “I believe that the only way we will eradicate cancer is through early detection, education and preventive measures, even if they seem extreme.”
Rockeymoore Cummings, who had the surgery Nov. 15, said Monday that the operation was successful and her recovery was going well.
Before the surgery, she said, she felt like she had “two ticking time bombs strapped” to her chest. “For me, it was more about removing the risk and moving forward knowing I’ve done everything I can to address it.”
She said she has spent the past several days in campaign mode, making fundraising calls and organizing, and plans to begin knocking on doors in the next couple of weeks. The Democratic primary is Feb. 4.
Despite advice — a lot of it from men, she said with a laugh — that she should postpone the surgery until after the campaign, Rockeymoore Cummings said she doesn’t regret prioritizing her health.
“You can’t run a campaign and be effective if you are sidelined or focused on health issues,” she said. “You have to do the things you need to do to be at your best, particularly representing people. We have to be in our best form to do that.”