The Links, Inc.

St. Louis-area chapters of The Links, Inc. received training to become breast health equity ambassadors and to share information about breast health and breast cancer prevention to the community from the American Cancer Society at a Breast Health Equity Symposium held February 1 at Parkview Tower at Barnes-Jewish Hospital.

Over 75 community members, most from the St. Louis area chapters of The Links, Inc., were part of a Breast Health Equity Symposium held February 1 at Parkview Tower at Barnes-Jewish Hospital. They trained to become breast health ambassadors in the community to spread breast cancer prevention facts and the importance of early detection to reduce breast health disparities.

Breast cancer is the most common form of cancer among women. American Cancer Society data says there are 265,000 new cases of breast cancer each year, and it is the second leading cause of cancer death among women – accounting for 40,000 deaths annually. (The number one killer is lung cancer.)

They discussed St. Louis County Health Department data which highlighted the differences in survival between African-American women and white women in the region.

“African-American women have a 90 percent higher mortality rate in the St. Louis region compared to white women,” said Links member and clinical oncologist Lannis Hall, MD, of Barnes Jewish Hospital, who chaired the symposium.

The Links organization has a national breast health initiative, and some local Links members recently completed e-learning modules on breast health, which stresses the importance of knowing family history and risk factors for breast cancer. Risk factors for breast cancer include family history and heredity, a history of biopsies, hormone replacement therapy, diets high in saturated fat, high alcohol intake, weight gain and obesity.

Links member Tawana Thomas-Johnson, national vice president for Diversity and Inclusion at the American Cancer Society in Baltimore, Maryland, was in St. Louis for the symposium. She said the Links and the ACS have a national partnership designed to support advancing the ACS mission in all communities, through its Health Equity Ambassador Links (HEAL).

“In St. Louis, there were approximately 50 Links that were trained as Health Equity Ambassadors,” Thomas Johnson told The American. “We talked a little bit about cancer disparities; about breast cancer disparities among black women; and we also conferred certificates upon the trained Health Equity Ambassadors who will be going out in the community to reach women with breast cancer prevention and early detection information.”

Hall said the symposium reinforced their e-training and put forth the Links’ next steps.

“Our call to action is to educate women and families in our communities about the importance of lifestyle modification for prevention of breast cancer and early detection through annual screening with mammography,” Hall said. “The Link sisters were educated on the Show Me Healthy Women program, which offers free screening to women who meet income and age guidelines. Each Link was called to education 20 women or more in the community who are not routinely screened.”

On average, African-American women are diagnosed with breast cancer at a younger age and at a more advanced stage. Hall said African-American women have a higher incidence of developing breast cancer under age of 45; one-third of African-American women develop breast cancer before the age of 50; and African-American women present with later stage disease and with more aggressive subtypes and pathologic features.

Hall said to stop cancer, you must spot cancer. She reminded participants that mammograms help to detect breast cancer before it is clinically apparent – giving health care providers a two-year lead time on survivorship, which is higher in women who get regular screenings. Breast cancer screenings have resulted in at 30 percent reduction in mortality, and high-risk women should consider MRI screening, Hall said.

In 2018, the Society of Breast Imagers and the American College of Radiology recommended adding black women to groups considered at high risk for breast cancer. They recommend that all African-American women should begin breast cancer screening by age 40, and they should begin discussions with their health care provider about screening at age 30. Breast cancer self-awareness should begin at age 20.

According to, other women considered in the high-risk category include women with a genetic mutation linked to breast cancer; those who have gotten chest or face x-rays; women of Ashkenazi Jewish descent; women with a strong family history of breast cancer, especially a parent or sibling; a personal history of breast cancer; women with dense breasts; and women who may have benign breast conditions.

Although the Links are leading it in St. Louis, Thomas-Johnson said they are making breast health equity a collaborative effort and partnership. The symposium also included Dr. Tim Eberlein, director of the Alvin J. Siteman Cancer Center; Dr. Denise Hooks Anderson, primary care physician; Dr. Ingrid Taylor, family medicine physician; Sherrill Jackson, founder  of The Breakfast Club support group for breast cancer survivors; Katie Manga of Gateway to Hope; a video by Susan G. Komen St. Louis; and Karen Morrison, Villajean Jones, JoAnne Wilson, Arlene Moore of The Links. The event was hosted by the Archway, Gateway and St. Louis chapters of The Links.

“It’s been incredibly successful,” Thomas-Johnson said of the Links’ breast health initiative. “We did it as a pilot initially in the eastern area of Links and had a lot of success there, and so it has just rolled out nationally this year. It’s a great way for the ACS to reach communities of color with messaging, and it’s being delivered by trusted messengers.”

For more information on the American Cancer Society, visit

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