Why Black Women Are at Higher Risk for Breast Cancer

Breast cancer is the second leading cause of cancer dead in the U.S., with the American Cancer Society (ACS) estimating that 55,720 new cases of ductal carcinoma in situ/stage 0 breast cancer and over 300,590 new cases of invasive breast cancer diagnosed in women in the U.S.

The good news is that earlier diagnoses, wider awareness, and improved treatment technology has resulted in a 43% drop in breast cancer fatalities over the last thirty years, a mortality gap persists between Black women and white women. 

This gap is extremely stark because even though White women have higher rates of being diagnosed with breast cancer, Black women are 40% more likely to pass from the disease.

The disparity is even more devastating among women under 50; although younger women in general have a higher likelihood of aggressive cancers, the mortality rate is twice as high among young Black women than young white women.

This disparity hasn’t budged for over a decade, and while there are factors such as socioeconomic disparities and screening practices we can analyze, research is still ongoing and there isn’t one specific cause doctors can pinpoint.

Understanding the facts and figures behind this disparity and the potential reasons why this disparity exists can help people make informed decisions regarding their personal health. 

Black Women More Likely To Be Diagnosed With Triple-Negative Breast Cancer

One of the driving forces behind the higher mortality rate for Black women with breast cancer is that Black women are two times more likely than white women to be diagnosed with triple-negative breast cancer.

Triple-negative breast cancer is unfortunately much less treatable than other types of breast cancer because it is progesterone-receptor negative, HER2-negative, and estrogen-receptor negative, which means that targeted medicine such as hormonal therapy cannot be used to treat the disease. More invasive, physically harsher types of treatments are typically required, such as chemotherapy, surgery, or radiation.

Moreover, triple-negative breast cancer is much more aggressive than other types of breast cancer, so it has a higher likelihood of spreading through the body to other organs and areas before it can be diagnosed. It is also more likely to come back after remission, creating deadlier outcomes for many patients. 

Black Women Have Higher Rates Of Early Breast Cancer

Another potential factor that increases the risk of Black women passing from breast cancer is that breast cancer among young Black women are higher than young white women and requires earlier screening practices – something that is compounded by access to preventative screening and treatment.

23% of all breast cancers in Black women were diagnosed before age 50, whereas only 16% of breast cancers in white women were diagnosed before age 50. Many national organizations don’t account for the prevalence of breast cancer cases in younger Black women who are under the age of 50.

Organizations like the U.S. Preventive Services Task Force, the American College of Physicians, and the American Academy of Family Practice recommend that women begin to get regular mammograms at the age of 50, which may not be the best practice for Black women considering the higher rate of diagnoses at younger ages.

This is why preventive breast cancer tests and screening is essential for Black women at a younger age, and access to care and education regarding this matter can save many lives.

Guidelines For Care Are Based On Studies Of White Women

As we discussed above, many preventive guidelines for breast cancer put out by national health organizations are not necessarily inclusive of all racial demographics.

Healthcare providers and public health professionals hard at work trying to lower the mortality rate among Black breast cancer patients focus on the key initiatives of increasing preventive screenings, promoting community education, and an emphasis on early detection.

Research targeting the ways that factors like socioeconomic status, race, and the ability to access care at different stages impact outcomes for breast cancer patients can help structure future intervention strategies that are more inclusive of the experience of all patients, helping lessen the disadvantage of certain when it comes to early detection. 

The Harvard Gazette announced some interesting findings that support the above statements that were published in the respected medical journal JAMA Surgery. According to the report, the current guidelines of major health organizations, which are based on data from mostly white populations, may result in delayed diagnosis in nonwhite women.

A team of Massachusetts General hospital investigators analyzed the racial disparity in clinical guidelines and discovered that racial differences in the stage of tumors at the time of diagnosis and patients’ ages illustrate a need for changing the guidelines to call for earlier initial screening of certain nonwhite women. 

Some facts and figures they found that could be applied to create new guidelines include:

• The average age at diagnosis for white women was 59
• The average age at diagnosis was 56 for black women
• The average age at diagnosis for Asian women was 46
• The average age at diagnosis for Hispanic women was 55
• Nonwhite women were diagnosed at higher percentages before age 50

Fortunately, if the information from these studies is applied correctly, the risks of overtreatment and overdiagnosis could be reduced through continued advances in clinical practice and screening technologies.

Non-white women specifically could be screened earlier, and earlier detection in minority patients could mitigate the costs of additional screenings, making it a win-win situation for healthcare providers.