What is the racial gap in breast cancer?
Breast cancer is the second leading cause of cancer death in women. According to the American Cancer Society, in 2021 alone, about 281,550 new cases of invasive breast cancer will be diagnosed in women, and around 43,600 women will die from breast cancer.
While breast cancer is not unique to one race— any woman can be diagnosed with it— it does affect racial groups differently. For example, although the incidences of breast cancer are the same for white and Black women, Black women are up to 40% more likely to die from it. Why is this the case?
What's behind the racial gap?
Some of the factors that fuel the differences between Black and white women when it comes to breast cancer include genetics and lack of access to insurance and healthcare:
The American Cancer Society has found that black women are more likely to be diagnosed with an aggressive subtype of breast cancer called triple-negative breast cancer (TNBC) that grows faster than other cancers and doesn't respond to hormone therapies or HER2 inhibitor treatments. While TNBC only accounts for roughly 10% to 15% of all breast cancer cases, it's up to three times more common among Black women. Doctors and scientists believe these incidences are linked to genes. One study found that the prevalence of TNBC was highest among women of West African, Caribbean, and Eastern African descent, respectively.
The good news is that TNBC tends to respond well to surgery and chemotherapy when it's caught early. Research also suggests that adopting a healthy diet, exercising, and other strategies can reduce the risk of genetically derived breast cancer.
2. Lack of access to insurance and healthcare, systemic racism, and implicit provider bias
Early detection is key to curing breast cancer. According to the CDC, breast cancer is more likely to be found earlier in white women than in Black women. One major cause for this disparity is that Black women (and other women of color) tend to lack access to quality healthcare due to institutional racism. More specifically, systemic racism is present in the employment sector, which means that people of color are under-represented in good-paying jobs that include health insurance as part of the benefits package. Most medical care providers recommend that their patients over 40 years of age get a mammogram every year, but this can be challenging for those that don't have health coverage or lack adequate coverage.
Implicit bias in the healthcare system is another factor that affects the quality of care Black women receive. According to the American Psychological Association, a 2003 report from the Institute of Medicine found that, “even when access-to-care barriers such as health insurance are controlled for, racial and ethnic minorities received worse health care than non-minorities, and that both explicit and implicit bias played potential roles.” These provider biases can negatively affect outcomes for breast cancer diagnoses in Black women and other women of color, leading to higher mortality rates.
What are some ways Black women can reduce their risk of breast cancer?
Despite statistics, there are many actionable steps that Black women can take to be proactive when it comes to breast health, including:
1. Find clinics that offer free or low-cost mammograms
Insurance companies are required by law to pay for mammograms every year to two for women aged 40 or over. But, if you don't have health coverage or are younger than 40, many clinics and programs offer free or low-cost mammograms. Check out organizations like Planned Parenthood, the CDC, and the Susan G. Komen foundation.
2. Learn more about your family history
If you know that a first-degree relative in your family, like your sister or mom, has had breast cancer, you should be genetically counseled. A genetic counselor will test you and explain the results so that you understand your firsts and the next best steps.
3. Conduct routine self-breast exams
Learning how to do a self-breast exam is important because many women can detect early signs of breast cancer themselves. Your PCP or OBGYN can teach you how to do a self-breast exam and look out for warning signs, such as a new hard lump, yellow, brown, or red nipple discharge, and any changes in the skin of the breast, such as redness, inflammation, or dimpling. You should conduct a self-breast exam at least once a month during the same time of your cycle.
4. Eat a balanced diet and exercise regularly
Many studies have found that an imbalance of estrogen within the body can increase susceptibility to certain types of breast cancer. But, diet and regular exercise can help keep estrogen levels appropriate for your body. Check out a nutritionist that specializes in cancer prevention to help with meal planning. Also, find movement that's fun for you and that you can do consistently.
5. Quit smoking
If you're a smoker, quitting can help to reduce your risk of cancer significantly. That's because smoking not only increases your chances of getting cancer but it can make cancer treatments less effective. There are many effective smoking cessation programs available.
Statistics don't represent the whole picture
While there is a significant disparity between black women and white women regarding breast cancer mortality rates, these statistics don't represent the whole picture. Each individual is unique and has their own personal experiences and histories. To figure out what's best for you in terms of cancer treatment or to reduce your risk of cancer, don't be afraid to reach out to your doctors or get second opinions if you need to. And if you're experiencing financial barriers to treatment, many clinics and organizations can help.