6 Things All Black Women Should Know About Breast Cancer

When it comes to breast cancer, which affects over 3.8 million women in the United States, Black women are frequently dealt a losing hand. This is because black women are 40% more likely than white women to die from the disease.

There are numerous reasons for this: Black people face health-care provider bias, may lack access to affordable and comprehensive care, and are more likely to be diagnosed later, often with more aggressive types of breast cancer in advanced stages. According to recent research, Black women are more likely to have cancers that metastasize, which means they are more difficult to treat because they have spread to other parts of the body.

Many people can reduce their cancer risk by maintaining a healthy weight, eating well-balanced, nutritious meals, exercising regularly, and limiting alcohol consumption. Still, there's a lot to learn, especially if you're a Black woman. Experts discuss how breast cancer affects Black women and offer a few key ways to try to avoid it in the future.

1. Black women are often diagnosed with more aggressive forms of breast cancer

Black women appear to be more vulnerable to aggressive breast cancers, such as triple-negative breast cancer (TNBC), which does not respond to hormone-targeted cancer therapies, and inflammatory breast cancer (IBC), which grows and spreads rapidly.

It's unclear why Black women are more likely to develop these aggressive cancers, but a complex set of factors—both genetic and environmental—is most likely at work.

2. Black women are underrepresented in clinical trials

To enact or experience change, you must be present in the room where it occurs. In the case of breast cancer, that "room" can include clinical trials that offer new and innovative treatments.

Unfortunately, Black women frequently do not participate in clinical trials for a variety of reasons, including mistrust of the medical community based on both past and present experiences, a lack of access, and simply not being diagnosed.

When these trials result in changes in standard practice, the adoption of these treatments into daily practice may be slow due to differences in provider knowledge and insurance coverage issues that are frequently encountered with new and expensive, but highly effective, therapies.

3. Black women tend to have denser breasts

Dense breasts indicate that you have more glandular and fibrous connective tissue than fat. Dense breasts are perfectly normal and quite common! Almost half of all women aged 40 and up who have mammograms have dense breasts.

However, it is important to note that they can be a risk factor for breast cancer. Women with dense breasts are 1.2 times more likely than women with average breast density to develop breast cancer. Furthermore, black women have denser breasts than white women. A mammogram is the only way to determine whether you have dense breasts based on feel or firmness.

4. Black women may have more estrogen exposure

Estrogen is a hormone that everyone is born with. It contributes to our ability to become pregnant and bear children. Long-term exposure to the hormone, on the other hand, can increase the risk of breast cancer. Estrogen promotes the growth of breast cancer cells. Every time the cells copy themselves, they are more likely to make a mistake as they grow.

While Black women do not necessarily have higher estrogen levels or more long-term estrogen exposure, they do have a higher likelihood of some key factors, such as starting their periods earlier than other racial groups,10 being less likely to breastfeed,11 and is more likely to be obese as defined by the medical community. In fact, having a healthy weight can reduce the risk significantly. So, if you have obesity, it’s a good idea to visit a dietician or talk to a weight loss surgeon.

5. Black women may need to get screened for breast cancer earlier

When it comes to breast cancer screening recommendations, they are not all the same. One thing they all have in common is that many guidelines suggest that mammogram screening before the age of 50 is a personal choice rather than a firm recommendation, at least for people at average risk. However, 23% of Black women are diagnosed with breast cancer before the age of 50.

Revisions to screening guidelines may be beneficial in detecting breast cancer in Black women earlier. Whether it's a lump or just a rash, dimpling of the skin, or an inverted nipple, it can all be symptoms of breast cancer, so we must be our own advocates.

6. Black women are often forced to be their own health advocates

Advocacy is essential, as is understanding your family history—a woman's risk of breast cancer nearly doubles if she has a first-degree relative with breast cancer, such as a mother, daughter, or sister.

This is easier said than done, and ultimately, it is the responsibility of medical providers to provide equitable care to all people. Self-advocacy, however, will remain critical for Black women navigating the health care system, including those with breast cancer, until systemic change makes that a reality.