Breast Cancer in Black Women: Facing the Challenges and Finding the Solutions

Breast Cancer in Black Women: Facing the Challenges and Finding the Solutions

Breast cancer is the most common cancer among women in the United States, affecting about one in eight women during their lifetime. However, not all women have the same risk or outcome of this disease. Black women, in particular, face higher rates of mortality, lower rates of survival, and more aggressive forms of breast cancer than white women. This article will examine the reasons behind these disparities and the possible ways to overcome them.

Why are Black women more likely to die from breast cancer?

According to the American Cancer Society (ACS), breast cancer death rates are 41% higher for Black women than for white women ¹. This means that for every 100 Black women who die from breast cancer, 59 white women would die if they had the same death rate. This gap has persisted for decades, despite the overall decline in breast cancer mortality for all women.

There are several factors that contribute to this disparity, including:

• Tumor biology and genetics: Black women are more likely to develop triple-negative breast cancer (TNBC), a subtype that is resistant to hormone therapy and targeted therapy, and has a poorer prognosis than other subtypes. TNBC accounts for about 20% of breast cancers in Black women, compared to 10% in white women ². Black women also have higher rates of mutations in genes that increase the risk of breast cancer, such as BRCA1, BRCA2, TP53, CHEK2, and PALB2 ³.
• Access to screening and care: Black women are less likely to have regular mammograms, which can detect breast cancer at an early stage when it is more treatable. According to a 2020 report by the ACS, only 54% of Black women aged 40 and older had a mammogram within the past year, compared to 65% of white women ⁴. Black women also face barriers to accessing quality health care, such as lack of insurance, transportation, or culturally competent providers. As a result, Black women are more likely to be diagnosed with breast cancer at a later stage and receive suboptimal treatment .
• Social determinants of health: Black women experience higher levels of poverty, unemployment, stress, and discrimination than white women, which can affect their health behaviors and outcomes. For example, poverty can limit access to healthy food, physical activity, and preventive care. Stress can weaken the immune system and increase inflammation. Discrimination can cause mistrust in the health care system and reluctance to seek help. These factors can increase the risk of developing breast cancer or worsen its prognosis .

How can we reduce the disparities and improve the outcomes for Black women?

To reduce the disparities and improve the outcomes for Black women with breast cancer, we need to take action at multiple levels, involving individuals, communities, health systems, and policies. Some of the possible actions are:

• Increasing awareness and education: Black women need to be informed about their risk factors, symptoms, screening options, and treatment choices for breast cancer. They also need to be empowered to advocate for their health and seek help when needed. Education campaigns, peer support groups, and patient navigation programs can help to increase awareness and education among Black women and their families.
• Improving access and quality of care: Black women need to have access to affordable, timely, and culturally appropriate breast cancer care. This includes regular mammograms, early diagnosis, optimal treatment, and follow-up care. Health care providers need to be trained and equipped to provide high-quality care that is sensitive to the needs and preferences of Black women. Health care systems need to address barriers such as lack of insurance, transportation, or language services that may prevent Black women from accessing care.
• Addressing social determinants of health: Black women need to have access to the resources and opportunities that can improve their overall health and well-being. This includes access to healthy food, physical activity, safe housing, education, employment, and social support. Policies and programs that address poverty, racism, discrimination, and violence can help to reduce the stress and trauma that may affect the health of Black women.
• Supporting research and innovation: Black women need to be included and represented in breast cancer research and innovation. This includes increasing the participation of Black women in clinical trials, studying the biological and genetic factors that influence breast cancer risk and outcome in Black women, developing new therapies and technologies that are effective and safe for Black women, and evaluating the impact of interventions that aim to reduce disparities in breast cancer care.

By taking these actions, we can hope to close the gap in breast cancer outcomes between Black women and white women, and ensure that all women have a fair chance of surviving and thriving after a breast cancer diagnosis.