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Breast Cancer: Black Women and Black Men

Is breast cancer more common in African Americans?

What race has the highest breast cancer rate?

Which racial or ethnic group has the highest mortality rate from breast cancer?

What ethnicity is more likely to get breast cancer?

 

Breast Cancer Awareness Month is a staunch reminder of the staggering disparities Black and African American women (and sometimes men) face.

 

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Variations in breast cancer between racial and ethnic groups

  • The median age of diagnosis is slightly younger for Black women (60 years old) compared to white women (63 years old).
  • Black women are more likely to develop breast cancer before age 40 than white women.
  • At every age, Black women are more likely to die from breast cancer than any other race or ethnic group.
  • White and Asian/Pacific Islander women are more likely to be diagnosed with localized breast cancer than Black, Hispanic, and American Indian/Alaska Native women.
  • Fewer than 1 percent of all breast cancer diagnoses are in men; however Black men have higher rates of all types of breast cancer, and breast cancer incidence rates were 52 percent higher in Black men than in white men in the U.S.

 

Inflammatory breast cancer (IBC) and triple-negative breast cancer (TNBC) disproportionately affect Black women and contribute to racial disparities in breast cancer mortality.

 

Delays in diagnosis and treatment for breast cancer may contribute to excess deaths among African Americans.

 

Black women have the highest death rate from breast cancer.

 

Risk Factors for Black Women and Breast Cancer

In addition to being female and having a personal history of breast conditions or a family history of breast cancer, several genetic, biological and lifestyle factors associated with an increased risk of breast cancer are prevalent among African American women and not easily altered.

 

Genetic Mutations

Two of the most well-known genes that can mutate and raise the risk of breast and ovarian cancer are BRCA1 and BRCA2. Although the rates of genetic mutations among Black and white women were similar, Black women diagnosed with breast cancer were more likely to have mutations in the BRCA2 and PALB2 genes than white women.

Black women with mutations in the gene PALB2 have a 58 percent lifetime risk of developing breast cancer (by age 85 years). White women are almost five times more likely than Black women to be referred for genetic counseling and testing, suggesting racial disparities in how some doctors refer patients for those services.

 

Dense Breast Tissue

Black women are more likely to have dense breasts, making it harder to detect breast cancer via mammograms and boosting the risk for the disease. Thirty-eight states, including Ohio, require some level of breast density notification after a mammogram. Women with the highest breast density have a four to six times greater risk for breast cancer than those with lower breast density.

 

Childbearing

Having the first pregnancy after age 30, not breastfeeding, and never having a full-term pregnancy can raise breast cancer risk. The median age of Black mothers at birth climbed from 24 years in 1990 to 28 years in 2019. Black women have the lowest breastfeeding initiation rate of all racial groups at 69.4 percent, compared with 85.9 percent of white women.

Fertility rates for Black women have declined slightly over the past 10 years, from 70.8 births per 1,000 women in 2008 to 62.0 per 1,000 in 2018. Approximately 15 percent of U.S. Black women aged 40 to 44 have no biological children.

 

Reproductive History

Starting menstrual periods before age 12 exposes women to hormones longer, raising their risk of getting breast cancer. The average age for periods in the U.S. is 12.16 for Black girls and 12.88 for whites. By age eleven, 28 percent of Black girls and 13.5 percent of whites menstruate.

 

Little or No Access to Health Insurance

Although significant health insurance gains since the Affordable Care Act (ACA) was implemented, pervasive coverage disparities remain for Black women. Nearly 14 percent of Black women are uninsured, and one in five low-income Black women is uninsured.

 

Inactive Lifestyle

Not being physically active or being overweight or obese after menopause increases the risk of getting breast cancer. Thirty percent of non-Hispanic Blacks have physical inactivity outside work, and 80.6 percent of non-Hispanic Black women are overweight or obese.

 

Smoking

Women who are current smokers and have been smoking for more than 10 years appear to have a 10 percent higher risk of breast cancer than women who have never smoked. Between 13 percent and 14 percent of African American women smoke tobacco.

 

Better Treatments for Triple Negative Breast Cancer

Breast cancer is an out-of-control cell growth that can be found in one or both breasts of women and, in rare occurrences, men. Cancer cells can spread into the blood or lymph system and progress to other body parts. Technology, medication, greater access, and a focus on culturally competent care improve outcomes for Black and African American women and men diagnosed with breast cancer.

Triple-negative breast cancers (TNBC) are the hardest to treat because they lack hormone receptors and HER2 overexpression, so they do not respond to therapies directed at these targets. Chemotherapy is the mainstay for the treatment of TNBC; however, new treatments are starting to become available:

For a more comprehensive list of the latest advances in all categories and stages of breast cancer treatment, visit the National Cancer Institute.

 

 

Better Breast Cancer Prevention Measures

Black and African American women can do more than diet, exercise, tobacco and alcohol cessation, self-breast exams, and annual mammography screening to help prevent breast cancer. Preventative measures for African American breast health are as follows:

  • Black women with a higher risk of breast cancer can request MRI (magnetic resonance imaging) and an ultrasound to detect breast cancer. A new technology being deployed in clinical settings is 3-D mammography, also called breast tomosynthesis, which takes images from different angles around the breast and builds them into a 3-D-like image.
  • Patients should be mindful of the potential for diagnosing tumors that would not have become life-threatening (overdiagnosis), the possibility of receiving false-positive test results, and the anxiety that comes with follow-up tests or procedures.
  • Women with specific patterns of breast, ovarian, tubal, or peritoneal cancer in any family history can order genetic counseling testing to determine the risk of breast cancer.
  • Estrogen-blocking pills are a newer preventative therapy. These pills are prescribed to high-risk patients for around five years, reducing development risk by nearly 30 percent.

 

 

Support for Black and African American Men and Women Diagnosed with Breast Cancer

Physical, mental, social, and financial support are available to Black and African American men and women diagnosed with breast cancer in Cincinnati and the U.S.

 

 

African American Breast Health Sources:

America Cancer Society (ACS)
Black Women Need Genetic Testing for Breast Cancer (ACS)
Lifetime Risk of Developing or Dying from Cancer
Good Morning America: Young women share breast cancer stories
Good Morning America: The latest advancements in the fight against breast cancer
Black Men have higher incidence rates of all types of breast cancer
Black Male Breast Cancer in the U.S Breastcancer.org
Babies After 35: Black Women and Infertility
Dr. Kristi Funk on GMA: New advancements in the fight against breast cancer
GMA: A look at the latest technology for breast cancer treatment

 

The Voice of Black Cincinnati is a media company designed to educate, recognize and create opportunities for African Americans in the region. Visit our homepage, explore other articles, subscribe to our newsletter, follow us on Facebook, or text VOBC to 513-270-3880 for local news, events, job postings, scholarships, and a database of local Black-owned businesses.

African American Breast Health photo provided by Adobe Stock

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Crystal Kendrick

Written by Crystal Kendrick

Publisher, The Voice of Black Cincinnati

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