While cancer sucks in general, breast cancer is the second leading cause of cancer death in the United States. The American Cancer Society (ACS) has estimated that 55,720 new cases of ductal carcinoma breast cancer and over 300,590 new cases of invasive breast cancer will be diagnosed in women in the U.S. this year. The good news is that earlier diagnoses, wider awareness, and improved treatment technology have resulted in a 43% drop in breast cancer fatalities over the last thirty years. However, a mortality gap persists between Black women and white women.
This gap is extremely stark because although white women have higher rates of being diagnosed with breast cancer, Black women are 40% more likely to die from the disease. The disparity is even more devastating among women under 50; although younger women generally have a higher chance of aggressive cancers, the mortality rate is twice as high among young Black women than young white women.
Understanding the facts and figures behind this disparity and the potential reasons why it exists can help individuals make informed decisions regarding their personal health.
Black Women More Likely to Be Diagnosed with Triple-Negative Breast Cancer
One of the driving forces behind the higher mortality rate for Black women with breast cancer is that Black women are twice as likely as white women to be diagnosed with triple-negative breast cancer. Triple-negative breast cancer is unfortunately much less treatable than other types of breast cancer because it is progesterone-receptor negative, HER2-negative, and estrogen-receptor negative, meaning that targeted medications such as hormonal therapy cannot be used to treat the disease. More invasive, physically harsher types of treatments are often required, such as chemotherapy, surgery, or radiation.
Moreover, triple-negative breast cancer is much more aggressive than other types of breast cancer, so it has a greater chance of spreading through the body to other organs and areas before it can be diagnosed. It is also more likely to come back after remission, creating deadlier outcomes for many patients.
Black Women Have Higher Rates of Early Breast Cancer
Another potential factor that increases the risk of Black women dying from breast cancer is that breast cancer among young Black women is higher than among young white women and requires earlier screening practices—something compounded by access to preventive screening and treatment.
According to statistics, 23% of all breast cancers in Black women were diagnosed before age 50, whereas only 16% of breast cancers in white women were diagnosed before age 50. Many national organizations don’t account for the prevalence of breast cancer cases in younger Black women who are under the age of 50.
Organizations like the U.S. Preventive Services Task Force, the American College of Physicians, and the American Academy of Family Practice recommend that women start getting regular mammograms at the age of 50, which might not be the best practice for Black women considering the higher rate of diagnoses at younger ages. Therefore, preventive breast cancer tests and screening are crucial for Black women at a younger age, and access to care and education regarding this matter can save many lives.
Guidelines for Care Are Based on Studies of White Women
Many preventive guidelines for breast cancer put out by national health organizations are not necessarily inclusive of all racial demographics. Healthcare providers and public health professionals working hard to lower the mortality rate among Black breast cancer patients focus on key initiatives such as increasing preventive screenings, promoting community education, and emphasizing early detection.
Studies focusing on how factors like socioeconomic status, race, and the ability to access care at different stages affect outcomes for breast cancer patients can help structure future intervention strategies that are more inclusive of the experience of all patients, helping reduce the disadvantage of certain groups regarding early detection.
The Harvard Gazette presented some interesting findings published in the respected medical journal JAMA Surgery. According to the report, the current guidelines of major health organizations, based on data from mostly white populations, may result in delayed diagnosis in nonwhite women. A team of Massachusetts General Hospital investigators analyzed the racial disparity in medical guidelines and found that racial differences in the stage of tumors at the time of diagnosis and patients’ ages illustrate a need for changing the guidelines to call for earlier initial screening of certain nonwhite women.
Some facts and figures they found that could be applied to create new guidelines include:
- The average age at diagnosis for white women was 59
- The average age at diagnosis was 56 for Black women
- The average age at diagnosis for Asian women was 46
- The average age at diagnosis for Hispanic women was 55
- Nonwhite women were diagnosed at higher percentages before age 50
Fortunately, if the data from these studies are applied correctly, the risks of overtreatment and overdiagnosis can be reduced through continued advances in medical practice and screening technologies. Nonwhite women, especially, could be screened earlier, and earlier detection in minority patients could mitigate the costs of additional screenings, making it a win-win situation for healthcare providers.
The disparities in breast cancer diagnosis and mortality between Black women and white women highlight the urgent need for inclusive, tailored healthcare practices. By understanding these differences and advocating for early screening and personalized care, we can work towards closing the gap and ensuring that all women receive the care and support they need.
