Why Do Black Women Have a Higher Breast Cancer Mortality Rate?

At the age of 32, Donna Hayes was not too worried about the lump she noticed in her breast. “My doctor told me, ‘you’re too young for breast cancer, so it’s more likely to be a cyst,’” Hayes said in a PBS Newshour program on Black women and breast cancer. 

Further testing revealed that it was not just a cyst — it was cancer. Fortunately, she was able to receive treatment and is currently in remission.   

“[Healthcare providers] shouldn’t tell you, ‘you’re too young; this can’t happen to you.’ Clearly it can happen,” Hayes said.  

As a Black woman, Hayes may be at higher risk for early breast cancer. Research has shown that Black women are more likely than their white counterparts to be diagnosed with breast cancer before the age of 50, indicating a potential benefit to screening these individuals earlier than is currently recommended. The mortality rate for Black women with breast cancer is also 42 percent higher, according to a study published by the American Cancer Society.

While the exact cause for this health disparity is unknown, many healthcare professionals and researchers attribute it to a combination of factors, including social determinants of health such as socioeconomic status, racial bias, and access to care.

As more is discovered about breast cancer in Black women, it is important for patients to feel empowered to seek care, for providers to focus on individualized care, and for public health professionals to continue diversifying their research.

While public health professionals and healthcare providers have made some effort to address racial disparities in healthcare, Black women who receive a breast cancer diagnosis still face poorer health outcomes.

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There are a variety of theories behind racial health disparities in breast cancer treatment. With regards to data on breast cancer and the resulting guidelines for care, a majority come from studies of white women, according to a Time magazine article on inclusive health care. It’s also important to note that Black women with breast cancer consistently receive their diagnosis at a later stage when the disease is more advanced. Additionally, Black women with breast cancer face a greater risk of having their cancer spread to other body parts — a disparity that is not readily explained by research. 

Access to preventive screenings is another issue that contributes to racial health disparities. Barriers to screening for Black women include lower income and lack of health insurance or contact with a primary healthcare provider. In addition to preventive care, Black women are less likely to receive surgery and other breast cancer treatment. 

What Is Triple-Negative Breast Cancer?

Black women are twice as likely as white women to be diagnosed with triple-negative breast cancer, which has fewer options for treatment than other types of breast cancer.  

• Triple-negative breast cancer is estrogen-receptor negative, progesterone-receptor-negative, and HER2-negative, meaning the disease cannot be treated through hormonal therapy or with other targeted medicine. 
• Instead, treatment for triple-negative breast cancer may require surgery, chemotherapy, or radiation. 

Additionally, triple-negative breast cancer is more aggressive, more likely to spread to other locations in the body before it is diagnosed, and more likely to return, potentially leading to poorer health outcomes for patients.

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The promotion of community education, efforts to increase preventive screenings, and a focus on early detection are all critical initiatives for public health professionals and healthcare providers working to reduce the mortality rate of Black breast cancer patients. 

Further research that focuses on how factors such as race, socioeconomic status, and access to care affect breast cancer patient outcomes can also inform future intervention strategies. For example, current guidelines for breast cancer screenings may fail to acknowledge the experience of all patients, leaving certain communities at a disadvantage for early detection. 

According to research published in JAMA Oncology, breast cancer diagnosed before age 50 represents 23 percent of all breast cancers in Black women, compared to only 16 percent of all breast cancers in white women.

Breast cancer screening guidelines from multiple national organizations do not acknowledge the prevalence of breast cancer cases in Black women under the age of 50. Organizations that recommend women start getting regular mammograms at age 50 include the U.S. Preventive Services Task Force, the American Academy of Family Practice, and the American College of Physicians.

Through support from their provider, friends, and family members, Black women can be encouraged to seek preventive screenings and tests for breast cancer at a younger age.

To inform these decisions, the Centers for Disease Control and Prevention recommends women should do the following: 

• Talk to family members to better understand their medical history and potential health risks.
• Pay attention to how their breast tissue normally looks and feels so that abnormalities can be addressed by a clinician.

African American Breast Cancer Alliance (AABCA) 

This organization’s mission is “building awareness, networking, resources, and support for Black women and men impacted by breast cancer.” AABCA offers programs for patients and survivors, as well as online resources. 

African American Women and Breast Cancer 

Created by Breast Cancer Prevention Partners, this fact sheet provides statistics as well as information on health risks and prevention.

Black Women and Breast Cancer: Why Disparities Persist and How to End Them

The Breast Cancer Research Foundation, a nonprofit “committed to achieving the end of breast cancer,” offers a number of online resources, including this article that addresses the issue of racial health disparities among breast cancer patients and how Black women can be informed about their health. 

Black Women’s Health Imperative (BWHI)

As an organization focused on Black women’s health, BWHI provides information and resources through specific health initiatives, including breast cancer prevention. 

Komen Breast Cancer Helpline

Powered by the Susan G. Komen Foundation, the Komen Breast Cancer Helpline allows individuals to call or email a support person for information on breast health, emotional support, and referrals to breast cancer resources. 

Sisters Network Inc.

Committed to increasing “attention to the devastating impact that breast cancer has in the African American community,” Sisters Network Inc. has multiple chapters and provides support to women with breast cancer and breast cancer survivors. 

Citation for this content: The MPH online program from Baylor University’s Robbins College of Health and Human Sciences