Black Women and Breast Cancer
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FACT: Black women tend to be diagnosed with breast cancer at a younger age. Access to equitable care is critical to receiving a timely diagnosis and treatment options.
The National Cancer Institute reports that among women, breast cancer is the most commonly diagnosed cancer after nonmelanoma skin cancer, and it is the second leading cause of cancer deaths after lung cancer.
The CDC states that breast cancer is the second leading cause of cancer deaths among women in the United States. Breast cancer deaths are decreasing fastest among white women.
Black women have higher numbers of advanced-stage breast cancer, 45 percent, compared with white women, 35 percent. Fewer Black women start treatment in a timely way compared with white women. Also, fewer Black women get the surgery, radiation, and hormone treatments they need compared with white women.
In 2012, an estimated 229,060 new cases will be diagnosed, and 39,920 deaths from breast cancer will occur.
Black women are twice as likely as White women to develop “triple-negative” breast cancer—a subtype of the disease.
Triple-negative breast cancer is a type of aggressive breast cancer that primarily affects young Black women. This cancer tests negative for estrogen receptors (ER), progesterone receptors (PR), and the HER-2 gene.
Women with triple-negative breast cancer don’t benefit from the most common treatments, such as tamoxifen or Herceptin, which are designed to affect cancers driven by estrogen or progesterone.
During a recent interview, Thomas R. Frieden, M.D., M.P.H, CDC Director explains that, “Although we are making progress reducing deaths from breast cancer, we have much work to do to reduce preventable deaths, particularly among African-American women.” He went on to say, “Only when every woman receives adequate screening, timely follow-up, and high-quality treatment, will the full benefit of breast cancer screening be achieved.”
Black Women and Breast Cancer
According to the CDC, Black women under the age of 35 are twice as likely to develop breast cancer than white women of the same age. A family history of breast cancer is a very strong risk factor for developing breast cancer when you are younger than 35, so knowing your family history is very important.
Breast Cancer Prevention
- Get screened for breast cancer regularly
- Control your weight and exercise
- Know your family history of breast cancer
- Limit the amount of alcohol you drink
- Breast-feed if you can: Based on solid evidence, women who breast-feed have a decreased risk of breast cancer
Breast Cancer Screening
Below are the general recommendations from The American Cancer Society for women at an “average risk” of breast cancer. If you have an average risk of breast cancer, this means that you do not have a personal risk of breast cancer, a genetic mutation known to contribute to breast cancer (such as the BRCA gene), or a strong family history of breast cancer. Your medical provider’s recommendations may be different depending on genetics, family history, and other risk factors.
- If you are aged 40 to 54: You should have a mammogram every year
- If you are older than 55: Your provider may tell you that you can switch to receiving mammograms every other year but you may also choose to continue having them every year.
Screenings should continue as long as you are in good health.
Mammogram
The first phrase that most women associate with breast cancer screening is mammogram. Mammograms are low doses of x-rays to the breast which help to detect breast cancer at early stages, which is when it is most easily treated. Mammograms can actually detect your breast cancer years before symptoms would appear, which is why it is important for you to receive regular mammograms. According to the American Cancer Society, women who have regular mammograms have a significantly greater chance of finding breast cancer at an earlier stage, which in turn decreases the chance of needing mastectomy or chemotherapy.
MRI
Instead of the x-rays used in mammograms, an MRI uses strong magnets to create a 3D image of the focused part of your body. A breast MRI is done with a special MRI machine that has features designed for breast imaging. Not all MRI imaging facilities have a machine with this feature so it is important to have your breast MRI at a facility with this capacity.
According to the American Cancer Society, breast MRI is mainly recommended if you are high risk or if you need a follow-up from your mammogram. If you are at high risk, you should get breast MRIs AND mammograms each year starting at an early age so please discuss with your medical provider. You may be considered high risk if you have a BRCA1 or BRCA2 gene mutation, a family history of breast cancer, or even family history of BRCA that have not been tested themselves.
It is important to note that while breast MRI can be generally more effective at detecting breast cancer than a mammogram, it can still miss certain types of breast cancer that a mammogram can detect. This is why the American Cancer Society recommends that high-risk patients receive both a mammogram and a breast MRI annually.
New 2023 Mammogram Recommendations from the U.S. Preventive Services Task Force
The U.S. Preventive Services Task Force (USPSTF) is an “independent, volunteer panel of national experts in disease prevention and evidence-based medicine.” On May 9th, 2023, the USPSTF updated their recommendation for breast cancer screenings to advise all asymptomatic people assigned female at birth to begin getting biannual mammograms at 40 years old instead of at 50. The new recommendation stems from a 2% increase in breast cancer diagnoses among women in their 40s and persistently high mortality rates among Black women. Screening 10 years earlier has potential to save thousands of lives as cancer growth may go undetected for years.
Risk Factors
- If you have undergone hormone therapy: Based on solid evidence, combination hormone therapy (HT; estrogen-progestin) is associated with an increased risk of developing breast cancer. The evidence concerning the association between estrogen-only therapy and breast cancer incidence is mixed (National Cancer Institute).
- If you are obese: Based on solid evidence, obesity is associated with an increased breast cancer risk in postmenopausal women who have not used HT.
- If you drink: Based on solid evidence, exposure to alcohol is associated with an increased breast cancer risk in a dose-dependent fashion. This means that the less you drink, the lower your risk for cancer. The CDC recommends that women have no more than one alcoholic drink a day.
- If you have genes associated with breast cancer: Based on solid evidence, women who inherit gene mutations associated with breast cancer have an increased risk. For more information on this, please see our section on the BRCA 1 and BRCA 2 genes.
ADDITIONAL RISK FACTORS:
Age, family history, reproductive and menstrual history. We also believe that medical, socioeconomic inequities and other social determinants of health can be contributing factors towards the development of breast cancer.
Treatment
Different types of treatment are available for patients with breast cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
For more comprehensive information on breast cancer treatment, please go to the National Cancer Institute.