“Breast cancer is the second most common cancer in women in the United States. A breast cancer diagnosis can be devastating. It is alarming to know that the color of someone’s skin can be a factor in their survival.”

The rate of breast cancer diagnosis is the same for both white and black women.

About 82% of Black women live at least 5 years after their initial breast cancer diagnosis, compared to 92% of white women. But Black women are 41% more likely to die from breast cancer even though their incidence rates are similar to or lower than those of white women.

Overall, Black individuals have the lowest survival of any racial/ethnic group for most cancers.

There are major barriers to getting a diagnosis.

  • Access to mammograms: Black women are more likely to go longer between routine mammograms. They’re also more likely to have a longer gap between an abnormal test and a follow-up mammogram.
  • Cost of healthcare: In the United States, Black people are more likely to be uninsured or underinsured. Data from 2019 show that around 10% of Black people in the United States did not have health insurance. About 6% of white people in the United States were uninsured.
  • Later stage diagnoses: Black women are more likely to be diagnosed with later stages of breast cancer. Research also shows that Black women are less likely to receive chemotherapy and surgery as part of breast cancer treatment.
  • Medical mistrust: There’s also ongoing medical mistrust among Black people. This is associated with fewer visits to doctors and worse health outcomes. About 25% of Black people in the United States report a high level of mistrust of doctors.

This stems from hundreds of years of racism and disparities that continue today for Black people. Many doctors incorrectly perceive that Black people feel pain differently. Black people often are not given the right type or amount of medications for pain management.

People with a race that increases their risk for breast cancer. Racist tendencies increase the risk for Black people. Structural racism creates barriers to access certain things.

It is a big part of why so many black women die from breast cancer.

Some factors increase the risk of breast cancer. Some people will not develop breast cancer. Some people who develop breast cancer have no risk factors.

Risk factors include:

  • getting older
  • Your first period is before the age of 12.
  • After the age of 55, women go through menopause.
  • A family history of breast cancer.
  • Having a certain type of genes.
  • Having dense breast tissue.

Black women are more likely to be diagnosed at younger ages than white women. The median age of diagnosis in Black women is younger, at 58 years old. For white women, the median age for breast cancer diagnosis is 62. Black women are also more likely to be diagnosed under the age of 45.

Compared to non-Hispanic white women, Black women are twice as likely to be diagnosed with triple-negative breast cancer (TNBC). This type of cancer is harder to treat and tends to spread faster.

There may be a link between inflammation and insulin resistance and TNBC. This may increase the risk for Black women. There may also be some genetic factors that increase the risk of TNBC.

Black women are more likely to have chronic health conditions. This is related to higher rates of poverty and less access to healthcare.

Rates of diabetes are higher in Black people. Data from 2017–2018 shows that in the United States, 12% of Black adults had diabetes. This is compared to 8% of white adults. Diabetes is associated with higher levels of several types of cancer, including breast cancer.

It’s unclear exactly why diabetes and breast cancer are connected, but inflammation may be an underlying factor for both conditions. There’s also a connection between diabetes and dense breast tissue. Dense breast tissue is a risk factor for breast cancer. It can also make it harder to find breast cancer at earlier stages.

Black women are less likely to be included in clinical trials. Clinical trials help to advance knowledge about breast cancer and its treatments. Trials explore new treatments that are only available to people who are part of the trial.

There are many things that prevent Black people from participating in clinical trials. Black patients can be harder to qualify for a clinical trial. exclusion criteria include certain health conditions that make a person ineligible to participate in a trial

It can be difficult to participate in a trial because of the time off work, travel, and other costs.

There are many things that healthcare professionals need to do to improve care for people of color.

Dr. Teresa Hagan Thomas is an assistant professor at the University of Pittsburgh School of Nursing. Her research focuses on supporting patients to become strong self-advocates. She is passionate about improving cancer care for all by ensuring that a patient’s needs and priorities are at the center of the care they receive.

“Models of patient navigation help patients coordinate care and often involve connecting patients to community resources who can assist with additional needs.”

Dr. Teresea Hagan Thomas is a doctor.

Thomas says that healthcare professionals have an increasing need for solutions to the issues of disparity.

Black women are more likely to be diagnosed with breast cancer.

Thomas says that healthcare professionals are working to increase screening rates for poor outcomes. Increasing screening participation can help individuals be diagnosed with cancer sooner when it is more local and less likely to spread.

There is a move to recognize how the social determinants of health affect survival. Thomas says that clinicians and researchers are recognizing the role of access to quality cancer care, both geographically and by insurance, and the financial burden in treatment.

Patients may be seen as nonadherent when they delay treatment. The reasons why treatment might be delayed can be addressed through this new lens.

Patients may delay diagnosis or treatment because of transportation, financial, or social support issues. Clinicians are trying to address root causes that result in poor treatment outcomes.

A model of care that includes patient navigators is being used more and more.

Patients are often connected to community resources who can assist with additional needs, according to Thomas. Additional needs may include housing, food, financial aid, and other essentials that are needed so that patients can focus on their treatment and well-being.

Changes to increase diversity in clinical trials are noted by Thomas. Clinical trials rarely reflect the US demographic, especially among Black populations. There is more effort being made to reduce the barriers to clinical trials participation.

Building trust with different communities is one of the strategies being used.

“Black women don’t have to fix a system that works against people of color. Major changes are needed to improve access to healthcare. Black women are not getting the care they deserve because of low income and lack of health insurance.”

There are things you can do.

Breast cancer detection can be aided by mammograms. A mammogram is a type of X-ray. It takes pictures of your breasts to make sure they are not different.

The early stages of breast cancer are usually not symptoms. A mammogram can detect breast cancer early. Ask your healthcare professional when and where to get a mammogram.

If cost is a barrier for you, talk with your healthcare professional about options. You can also contact the Susan G. Komen Foundation. Their website has resources to find free or low cost mammograms near you.

Talk to your doctor if you notice any changes to your breasts. Mammograms are important because breast cancer in the early stages may not have any symptoms.

It is smart to watch for any changes.

  • “It’s dimpling in the skin of your breast.”
  • There is swelling in your breast.
  • There is pain in your nipple.
  • A lump in your breast.
  • There is a swollen Lymph nodes under your arm.
  • discharge from your nipple

“You need a healthcare professional who listens and understands you. If you don’t feel like you’re being met, look for someone else to work with.”

You need a support network if you have been diagnosed with breast cancer. Support groups and family are great places to meet. It is possible to have a trusted family member or friend attend your medical appointments.

If the cost of healthcare is a problem, there are organizations that can help. The American Cancer Society has some resources available.

Ask your healthcare professional if there is a social worker on the team. This person can help you find local resources.

Black women have higher death rates from breast cancer.

There are challenges in accessing healthcare. Black women are more likely to be uninsured. There are high levels of medical distrust. Systemic racism is being seen as a factor in health.

Change can happen when healthcare professionals understand the barriers that Black women face in diagnosis and treatment.