The Diverse Experience of Breast Cancer
Breast Cancer Disparities in the Black Community
Written by: Alexandra Qualls
Alexandra Qualls is the Marketing Strategy & Social Media Coordinator for Going Beyond the Pink and a junior at the University of North Carolina Wilmington studying Marketing Strategy.
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Cultural taboos within and systemic barriers against particular ethnic groups have left the Black community vulnerable to numerous inequalities in screening, diagnosing, and treatment of breast cancer which have, unfortunately, left Black women and men with the highest breast cancer mortality rate of any ethnic group in the United States.
BreastCancer.org tells us that breast cancer is the second leading cause of cancer deaths for women in the United States, and as of January 2022 statistics show there are more than 3.8 million women with a history of breast cancer in the U.S. This number includes those in treatment and successfully out of treatment, and is a number that has been climbing as technology and medicine develop and improve over time. While it is heartwarming to watch as more and more patients become cancer survivors, such a number provides a lot of data to glean knowledge from, and one conclusion that is becoming more widely known is that of the disparity between Black and White women in terms of success rates and stage at time of diagnosis.
According to the Breast Cancer Prevention Partners, Despite the universal drop in mortality rates, the incidence of breast cancer in African American women seems only to rise. The mortality rate for Black women diagnosed with breast cancer is 42% higher than in white women, and African-American women are said to have marginally lower survival rates five years post-diagnosis. For comparison, the five-year survival rate for white women is 90%, while for African American women it is roughly 78%.
BreastCancer.Org reminds us that like Black women, Black men too find themselves disproportionately likely to die from breast cancer than their White counterparts and are approximately three times as likely to die.
“Black women and white women get breast cancer at about the same rate, but the mortality rate for diagnosed black women is 42% higher, and the five year survival success rate is 12% lower. ”
The disparity between the mortality rates of Black and White women is shocking, especially given the technological and cultural advancements of today, and leaves one with many questions.
One in particular sums them up:
How can this be?
Professors at the University of Texas MD Anderson Cancer Center have a few ideas, namely insufficient screening and treatment, as well as genetic and biological predispositions that differ from other ethnic groups.
Triple-negative breast cancer (TNBC) is a fairly aggressive form of breast cancer that is especially immune to many targeted treatments used to block tumor growth. This form of cancer can grow and spread quite quickly, and according to the Diana Price of Cancer Connect, Triple negative breast cancer is also twice as common in American women of African descent when compared to those of European descent, accounting for approximately 30% of all cases.
Furthermore, Black women in America have higher odds of developing denser breast tissue than their White counterparts, which can carry it’s own set of unique screening and treatment needs! Dense breast tissue can often make mammograms less sensitive and harder to read, and can often require supplemental screening and ultrasounds. In an article published by the Oxford on the Determinants of Mammographic Breast Density they found increased odds of extremely dense tissue and reduced odds of heterogeneously dense breast tissue in African American women in comparison to non-Hispanic white women.
Remember, be the best advocate for yourself and your health that you can be. That said, this sometimes requires giving your doctor a special push.
The likelihood of developing either TNBC or dense breast tissue is partially attributed to genes, and scientists have begun to research this and inquire as to why certain ethnic groups have a higher propensity for this form of cancer to find better ways to treat it. In the meantime, they have issued a few advisements for those with a family history of breast cancer or for those who think they may be showcasing symptoms of any form of breast cancer. Healthline recommends the following;
Where it is usually recommended that women begin regular mammograms at 40 years old, its suggested that African American women have a mammogram or ultrasounds earlier in age, particularly if there is family health history of breast cancer.
While all women should partake in periodical breast self-exams, consider performing them more regularly.
Consider unique screening and treatment approaches.
Prevention is key.
You hear this time and time again as you grow older, but it rings true every time. Abeena Brewster, MD, MHS, and associate professor at the University of Texas MD Anderson Cancer Center spoke with CancerConnect to share that a key factor contributing to the distressing mortality rates of black women lies within time of diagnosis. Approximately 45% of black women have cancer that has spread beyond the breast upon first diagnosis, in comparison to 35% of white women. We also know that the time between diagnosis and the start of treatment is longer for black women than for white, indicating barriers to treatment at that phase.
Brewster places a huge emphasis on inadequate screening, inadequate treatment, and a general lack of accessibility and availability of resources in certain communities in perpetuating the disparity between diagnosis and mortality rates.
“We hope to have better screening rates, and this might help with stage at diagnosis. And, hopefully, access to care will improve, and this will level the playing field and allow all women to be treated.”
The inequalities seen between diagnosis and mortality rates in Black Americans in comparison to their ethnic counterparts are complex and intermingled in political, moral, and socioeconomic theories stemming from wealth inequalities as well as differences in housing, standards of living, education, and with consideration for barriers to early detection, cancer prevention, and treatment services that marginalized groups may often face. This is outlined in further studies done by Claire EL Jones and Joe Maben. Giving these inequalities consideration is necessary to help bridge the health gap between Black and White Americans with breast cancer and to lessen the mortality rate of breast cancer plaguing the African American community.
As a National Resource, The Sisters Network Inc. is a national African-American breast cancer community committed to increasing education and awareness and reducing the the disparity and impact of breast cancer in the Black community. Check out their website here.
To learn more about tracking your Family Health History and for your very own FREE tracker, check here!
For more information about the genetic risks of breast cancer, see our blog post here!
For recently updated CDC statistics on breast cancer rates by U.S. states, demographics, and trends, see their website here!