Historically, Black women have been less likely to be diagnosed with breast cancer than white women. Still, breast cancer in Black women is typically more aggressive than breast cancer in white women. Compared to white women, breast cancer in Black women tends to be:
- diagnosed at a younger age
- more advanced at diagnosis
- more likely to be fatal at an earlier age
Now, a large study by the U.S. Centers for Disease Control (CDC) has found that overall rates of breast cancer in Black and white women are now about the same, but Black women older than 50 continue to be more likely to die from breast cancer than white women.
The study was published in the October 14, 2016 Morbidity and Mortality Weekly Report. Read “Patterns and Trends in Age-Specific Black-White Differences in Breast Cancer Incidence and Mortality -- United States, 1999-2014.”
To do the study, researchers looked at breast cancer rates in women between 1999 and 2013 and deaths from breast cancer between 2000 and 2014, using information from the United States Cancer Statistics report.
About 221,000 cases of breast cancer were diagnosed each year from 2009 to 2013. Overall, rates of breast cancer were similar between Black women and white women:
- 121.5 cases of breast cancer were diagnosed per 100,000 Black women
- 123.6 cases of breast cancer were diagnosed per 100,000 white women
Still, there were differences by age and stage of the disease:
- Compared to white women, Black women older than 60 had higher rates of breast cancer.
- Compared to white women, Black women age 60 and younger had lower rates of breast cancer.
- More white women were diagnosed with breast cancer that had not spread to the lymph nodes (64%) compared to Black women (54%).
- Among white women, breast cancer rates decreased from 1999 to 2004, then leveled out, decreasing about 0.8% per year on average.
- Among Black women, breast cancer rates were stable from 1999 to 2005, then increased slightly.
- From 1999 to 2004, rates of breast cancer only decreased among white women age 50 and younger.
- From 1999 to 2013, in women 60 to 79 years old, rates of breast cancer decreased among white women but increased among Black women.
When the researchers looked at mortality rates, they found that about 41,000 women died from breast cancer each year from 2010 to 2014.
Breast cancer mortality was 41% higher among Black women than white women:
- 29.2 Black women died from breast cancer per 100,000 women
- 20.6 white women died from breast cancer per 100,000 women
Deaths from breast cancer dropped from 2010 to 2014 among all women, though, again, there were differences by race and age:
- Overall, breast cancer mortality rates dropped faster among white women (decreasing 1.9% per year) compared to Black women (decreasing 1.5% per year).
- Among women older than 50, breast cancer mortality rates decreased at the same pace in Black and white women.
- Among women age 60 to 69, breast cancer mortality rates dropped 2% per year in white women and 1% per year in Black women.
It’s not completely clear why more Black women are being diagnosed with breast cancer, as well as why a higher proportion of older Black women continue to die from breast cancer.
More Black women getting screening mammograms could lead to more breast cancer being detected. The report also calls out lack of exercise and increasing rates of obesity among Black women as potential reasons.
Otis Brawley, chief medical and scientific officer for the American Cancer Society, said in an interview that access to care could also be a big reason.
“Forty to 50% of Black women get less than optimal care for breast cancer, whether it’s mammography or treatment,” he said. “We need to focus on getting good care, high-quality care, to everybody.”
Most experts think that it’s likely to be a combination of factors. Rising obesity rates among Black women, coupled with statistics showing that more Black women are having fewer children and having children later in life could play a role. We also know that Black women are less likely to participate in clinical trials testing new breast cancer treatments. Some doctors think that it’s possible that some medicines work differently or less effectively in Black women.
Women of all ethnicities can take steps to keep their risk of breast cancer as low as it can be. If you’re a Black woman, you may want to talk to your doctor about your risk of breast cancer, as well as about lifestyle choices you can make to lower that risk, including:
- maintaining a healthy weight
- exercising every day
- limiting or avoiding alcohol
- not smoking
- eating a healthy diet that’s low in processed foods, sugar, and trans fats
To learn more about breast cancer risk and other options to keep your risk as low as it can be, visit the Breastcancer.org Lower Your Risk section.
If you’ve been diagnosed with breast cancer, you and your doctors will put together a treatment plan that meets the needs of your unique situation and takes into account your overall medical condition and your personal style of making decisions.
If you’re not comfortable with the treatment plan your doctor recommends or want to see if another doctor recommends the same options, you may want to consider getting a second opinion from another doctor.
Many women diagnosed with breast cancer feel a sense of urgency about jumping right in and starting treatment immediately. In most cases, though, there’s time to do some research to make sure your diagnosis is correct and your treatment plan makes sense -- and this may include getting a second opinion.
Getting a second opinion means asking another breast cancer specialist, or a team of specialists, to review all of your medical reports and test results, give an opinion about your diagnosis, and suggest treatment options. A second opinion may confirm your original doctor’s diagnosis and treatment plan, provide more details about the type and stage of breast cancer, raise additional treatment options you hadn’t considered, or recommend a different course of action. Even if you’ve already had treatment, it’s not too late to get a second opinion. A second doctor can weigh in on your diagnosis and treatment plan to date, offering any additional thoughts or recommendations.
No matter your age or ethnicity, you absolutely deserve the best medical care possible. Don’t be afraid to ask questions and advocate for your care.
For more information on planning your treatment and getting a second opinion, visit the Breastcancer.org Treatment & Side Effects section.
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