Breast Cancer Prevention Treatment And Health Disparity
A 2006 report from the NCI-supported research showed that aggressive forms of breast cancers are common in younger African American/Black and Hispanic/Latino women living in low SES areas. These aggressive forms of breast cancer such as triple negative breast cancer are less responsive to standard cancer treatments and are associated with poorer survival . Triple-negative breast cancer is a heterogeneous disease in which tumors are defined by lack of expression of the estrogen receptor, the progesterone receptor, and the human epidermal growth factor receptor 2. It account for about 10â20% of invasive breast cancers and this subtype carries a poorer prognosis than the luminal tumors . There are no targeted therapies currently available for the treatment of triple-negative breast cancer.
Why Do More Black Women Die Of Breast Cancer
Breast cancer is deadlier for Black women than for women of any other race or ethnicity. This is true of all age groups. Black women also survive the shortest length of time after diagnosis. Theyâre 41% more likely to die from breast cancer than white women.
Experts think higher rates of triple-negative breast cancer is a big factor. Itâs more aggressive and has fewer treatment options. But there are other reasons for this racial disparity, including:
Structural racism. In general, Black people are less likely than white people to have access to health insurance or high-quality medical care. And black women are less likely to get breast cancer screenings at facilities with the most advanced imaging technology.
Experts blame disparities in health care largely on decades of racial discrimination and inequality.
If youâre a Black woman with breast cancer, racism roadblocks can make it so youâre:
- Less likely to get timely treatment
- Less likely to receive the right treatment
- More likely to get diagnosed with advanced disease
While itâs clear that systemic racism negatively affects health, there is so much more research to be done. In the meantime, experts hope to find ways to address some of these barriers. Some examples are:
- Including more Black women in breast cancer research
- Addressing racial bias among health care professionals
- Providing financial incentives for health systems that do well with mammogram screenings
Breast Cancer Is A Major Health Concern For Black Women Of All Ages Why
Black women are more likely to die from breast cancer than women from other ethnic groups.
African American women are more likely to be diagnosed with breast cancer at later stages of the disease and experience delays in treatment of two or more months after initial diagnosis. Long intervals between screenings, lack of timely follow-up of suspicious results, and delays in treatment after diagnosis likely contributes to the lower survival among black women.
Fear, mistrust of the healthcare system, belief in myths about cancer and lack of access to affordable healthcare following a breast cancer diagnosis can prevent a woman from taking action to manage her physical health.
Higher death rates among black women likely reflect a combination of factors, including differences in stage of cancer at diagnosis, comorbidities, obesity rates, tumor characteristics, as well as timely access to screening, diagnostic and treatment services. Black women have twice the risk of Triple-Negative breast cancer, an aggressive type of the disease. We also have a higher risk of BRCA1 and BRCA2 genetic mutations that carry a higher risk of breast cancer.
These facts are putting a tremendous burden on black women, families and communities. However, despite the statistics many black women are alive and well today because of early detection, diagnosis and treatment that can lead to great long-term results.
Also Check: Does Tumor Size Matter In Breast Cancer
Racial And Ethnic Disparities In Breast Cancer
Asian-Americans who have recently immigrated to the U.S. show lower rates of breast cancer than those who have lived in the U.S. for many years. However, for Asian American women born in the U.S., the risk is about the same as that of White women . The breast cancer 5-year relative survival rate has increased significantly for both Black and white Women in the last 40 years. Still, substantial racial gap remains. A 5-year survival rate was observed to be 81% for Black women and 92% for White women in recent years .
Chinese and Japanese women have the highest breast cancer survival rates whereas Black women have the lowest survival rate of any racial or ethnic group . Overall, breast cancer mortality rate is still higher among Black women compared to White women and other ethnic groups . The gap in breast cancer mortality rate among Black women continues to increase. For example, a report between 2000 and 2010 indicated that breast cancer mortality increased from 30.3% to 41.8% among African American women and that at the advanced stage, 5% of breast cancers are detected among White women compared to 8% of breast cancers among Black women .
When Should Black Women Start Getting Breast Cancer Screenings
According to research published in JAMA Oncology, breast cancer diagnosed before age 50 represents 23 percent of all breast cancers in Black women, compared to only 16 percent of all breast cancers in white women.Breast cancer screening guidelines from multiple national organizations do not acknowledge the prevalence of breast cancer cases in Black women under the age of 50. Organizations that recommend women start getting regular mammograms at age 50 include the U.S. Preventive Services Task Force, the American Academy of Family Practice, and the American College of Physicians.
Through support from their provider, friends, and family members, Black women can be encouraged to seek preventive screenings and tests for breast cancer at a younger age.
How Common Is Breast Cancer Among Black Women
Breast cancer makes up 30% of all cancers found in women. About 12% of Black women get it during their lifetime. They have the second-highest rates of breast cancer compared to other races. Black women are also more likely to:
- Get diagnosed with breast cancer before age 40
- Have certain aggressive breast cancers
- Have obesity and other health conditions
- Get diagnosed with advanced breast cancer
Breast cancer rates have recently slowed and stabilized for Black women.
Breast Cancer In Black Women
This article is part of Breast Cancer in Black Women, a destination in our Health Divide series.
Finding a lump in your breast can be terrifying. Whether it is discovered during a routine physical, self-exam, or incidentally when youre putting on deodorant, its understandable that you might imagine the worst when you notice something in your body that should not be there.
Fortunately, most breast lumps are noncancerous. There are many more common and benign conditions that cause lumps in the breast, including collections of fluid, deposits of fat, and deposits of calcium.
Greater awareness has eased tensions for some, but for many Black women, simply being more aware of the potential outcomes does little to address their fears.
This article specifically addresses the effect of breast cancer on Black women.
Verywell / Julie Bang
You May Like: Can You Have Your Breasts Removed To Prevent Cancer
Where To Find Support
Itâs OK to get a second opinion from another breast cancer doctor. You can do this anytime you want, but especially if you feel your doctor isnât taking your concerns seriously.
Some health resources and groups offer health support with Black women in mind. Some are geared toward those whoâve been diagnosed or treated for breast cancer. Others focus on general health issues that affect Black women and girls.
Some of those groups include:
- African American Breast Cancer Alliance
- Black Womenâs Health Imperative
- Sisters Network Inc.
Breast Cancer Death Rates Are Highest For Black Womenagain
ACS researchers report and explain statistics about breast cancer in a new article in CA: A Cancer Journal for Clinicians and in Breast Cancer Facts & Figures 2022-2024.
A new American Cancer Society report finds that the death rate for breast cancer in the United States among women dropped 43% between 1989 when it peaked and 2020. During the last decade, death rates declined similarly for women of all racial/ethnic groups across the US except for American Indians/Alaska Natives , who had stable rates. However, Black women are still more likely to die from breast cancer than White women across the US, even though Black women have lower breast cancer incidence rates.
We have been reporting this same disparity year after year for a decade. The differences in death rates are not explained by Black women having more aggressive cancers.
It is time for health systems to take a hard look at how they are caring differently for Black women.
Rebecca Siegel, MPH, senior scientific director of ACS Cancer Surveillance and co-author of the study
Here’s an overview of some key statistics from both reports.
Don’t Miss: How Is Breast Cancer Transmitted
Breast Cancer Risk: Disparities That Affect Black Women
In the United States , about 1 in 8 women will develop breast cancer in their lifetime. Black women have slightly lower rates of breast cancer than White women, but they have a significantly higher risk of developing more aggressive triple-negative breast cancers . This and other factors make Black women 41% more likely to die from breast cancer than their White peers.
This article explores why Black women are more at risk for aggressive forms of breast cancer, the factors that increase this risk, and the racial disparities in breast cancer care.
FatCamera / Getty Images
What Contributes To Disparity In Rate Of Breast Cancer And Related Deaths
The following chart summarizes factors that contribute to cancer health disparities. It is important to note that most of these factors are the result of structural and systemic racism in our health care system.
CancerDisparitiesProgressReport.org . Philadelphia: American Association for Cancer Research ©2020 . Available from
Recommended Reading: Can You Get Breast Cancer Without Brca Gene
If You Have Dense Breasts You Might Need Additional Screening Tests
About half of women undergoing mammograms have dense breast tissue. Though it’s common and normal, many women with dense breast tissue are unaware of it. A radiologist who analyzes your mammogram can determine the level of density on your breast.
“Breast density is a problem because on a mammogram, dense breast tissue looks white or gray, and cancers also look white or gray. It’s possible for breast density to hide cancer in the breast,” says Dr. Northfelt. “There are various techniques that we can use to overcome that. We have contrast-enhanced mammography, MRIs and ultrasound exams that can help overcome the problem that breast density creates and allow us to see the breast tissue more clearly.”
Women who are younger, have less body fat or take hormone therapy for menopause are more likely to have dense breast tissue, but the only way to know with certainty is to talk to your health care professional and determine the best screening test for you.
“It’s important for women to understand their breast density and seek better answers if they’re told they have dense breasts without further explanation. That’s not satisfactory,” says Dr. Northfelt.
Access To Screenings And Care
Black women have similar breast cancer screening rates as White women but are more likely to be diagnosed in later stages of the disease once breast cancer has spread to other areas of the body. This may be due to a lack of access to more advanced screening methods.
Digital breast tomosynthesis , or 3D mammogram, is an advanced form of breast imaging that detects 20% to 65% more invasive cancers. Though it is better able to detect aggressive cancers, Black women are given fewer DBT screenings than other racial/ethnic groups.
Delays in care may also contribute to high mortality rates. For example, one study found that Black women waited an average of 29 days for a biopsy following an abnormal breast cancer screening, compared to 20 days for White women. After diagnosis, up to 1 in 7 Black women experience delays of 60 days or longer before treatment begins.
Recommended Reading: What Genes Are Mutated To Cause Breast Cancer
When To Get Checked
One of the most important ways to reduce the risk of breast cancer is to try to detect it early. Black females should have regular breast screenings and see a healthcare professional immediately if they notice any changes in their breasts.
People can examine their own breasts in addition to regular breast screenings. This may help detect breast cancer earlier.
The U.S. Preventive Services Task Force currently recommend that females aged 5074 years have breast cancer screening every 2 years.
Those who are between 40 and 49 years of age should contact a healthcare professional to discuss whether regular breast cancer screening is the right choice for them.
If a person has a family history of breast or ovarian cancer, a doctor may recommend regular screening.
People should contact a healthcare professional immediately if they notice any changes in their breasts. The earlier people catch breast cancer, the higher their chances of survival.
Access to culturally competent healthcare is vital. Some people may be more comfortable seeing a Black physician.
BlackDoctor.org is a website where Black people can find doctors in their insurance network.
Receiving a breast cancer diagnosis and undergoing treatment can be difficult.
People may notice an adverse effect on their emotional, psychological, and mental health.
Why Is Breast Cancer More Deadly In African American Women
The causes of these breast cancer disparities are varied and speculative, and the subject of ongoing research here at Roswell Park. Some of the factors that may play a role include:
- African American women tend to get more aggressive subtypes of breast cancer, such as triple-negative breast cancer.
- African American women tend to develop breast cancer at a younger age. Premenopausal breast cancer also tends to be more aggressive, is more likely to recur, and when it does recur, its more difficult to cure.
- Gaps in care, such as a delay in start of treatment or women not being offered the same treatment options at the same time.
- Issues of mistrust by women of color with the medical establishment, which can impact care as well.
- Genetic differences between races
A breakthrough discovery in this research was the finding that African American women who breastfed their babies were less likely to develop the aggressive triple-negative subtype of the disease.
Worried about your breast cancer risk? Complete our online risk assessment form as a first step toward understanding personal risk level.
Recommended Reading: Can Ca125 Detect Breast Cancer
What Exactly Is The Disparity
Breast cancer disparity is complex and multifaceted. To begin with, Black women have a lower incidence rate but a higher mortality rate of breast cancer compared with their White counterparts. Translated, that means African-American women are less likely to develop the disease but more likely to die from ita lot more likely, in fact.
Black women have the highest breast cancer death rates of all racial and ethnic groups and a 41 percent higher rate of breast cancer death than White women.1,2 That is not a typoits a staggering statistic: Black women with breast cancer are 41 percent more likely to die from the disease than White women. Whats more, African-American women are less likely to survive for five years after diagnosis.3
The blame doesnt lie with just triple-negative breast cancer, however. More-recent research has found that Black women have a worse prognosis than White women regardless of breast cancer subtype.5
The bottom line: African-American women experience a triple whammy when it comes to breast canceryounger age at diagnosis, more-aggressive types of cancer, and higher mortality rates.
Breast Cancer Treatment Options
Women with breast cancer have more treatment options than ever before. The right treatment for you will depend on your tumor type, its characteristics, your overall health, and your lifestyle. The following types of treatment are used for breast cancer:
Surgery. Most women with breast cancer will have surgery to remove their tumor. To try to prevent cancer from coming back, surgery may be combined with other types of treatment.
Types of surgery used to remove tumors include:
Lumpectomy: Removes only the tumor and a small amount of the tissue surrounding it. This kind of surgery is usually followed by radiation.
Mastectomy: Removes the entire breast that has the tumor. After a mastectomy, reconstructive surgery can rebuild your breast so it is about the same size and shape as it was before.
Chemotherapy. Chemotherapy refers to drugs that kill rapidly dividing cells. This type of treatment kills cancer cells, but harms some healthy cells as well, which can lead to various side effects.
Targeted treatments. These are newer drugs designed to kill only cancer cells, not healthy cells. They usually have different side effects than traditional chemotherapy.
Hormonal therapy. Some breast cancers grow in response to the hormones estrogen and progesterone. Hormonal treatments block these hormones or reduce their amount in the body.
Radiation. Radiation refers to the use of special high-energy beams to stop cancer cells from growing and multiplying.
You May Like: Breast Cancer In Lymph Nodes Prognosis
A Doctor Who Looks Like You
As a physician and Black woman, Bea believes that a main inhibitor for the Black community to seeking health care is the absence of doctors who can relate to their life experiences. Only 5% of U.S. doctors are Black, and even fewer are Black women, per 2018 data.
“When I take care of my Black patients … I can’t tell you how often I hear, ‘I trust you because you look like me,'” she said. “I hear stories of, ‘I talked to this doctor, and I told them I had a mass, and they told me it was nothing,’ or, ‘I had a pain, and they said it was in my head.’ Unfortunately women are sometimes not taken seriously.”
While Vincent doesn’t feel her care team approached her differently because of her race, she said she leaned heavily on the only Black medical professional she encountered during her treatment.
In Vincent’s initial appointments, she recalled, staff struggled to draw her blood, and she had to be pricked by multiple techs each time, especially uncomfortable given her fear of needles. So the Black medical assistant planned her future visits so the one tech who could draw Vincent’s blood on the first try was always available.
“She made it a point to really get close to me,” Vincent said. “It was almost like she rode this journey with me. She wanted to make sure I felt comfortable in the office. … It made a big difference.”