*What women
of color should
know about metastatic breast cancer.

 

According to the Black Women’s Health Imperative (BWHI), Black women are more likely to receive a diagnosis of metastatic breast cancer, be younger at diagnosis, and have more fatal outcomes than white women.

*What are some of the differences in the way breast cancer presents in Black women (AA) vs Whites (WA)? Age?

Breast cancer mortality/death rates are approximately 40% higher among African American women compared to White women.

African American women are more likely to be diagnosed with more advanced-stage breast cancer compared to White women; the tumors of AA patients are more likely to be larger and associated with spread to the axillary (underarm) lymph nodes (glands) at time of diagnosis compared to WA patients.

Risk of developing a breast cancer increases in ALL women as we get older, but AA women are more likely to be diagnosed with breast cancer at younger ages compared to WA women. For example, among women younger than 40-45 years old, the population-based incidence rates of breast cancer are higher for AA compared to WA women. Furthermore, approximately 30% of all newly-diagnosed AA breast cancer patients are younger than 50 years old, compared to only 20% of WA patients.

*Does it tend to be more aggressive
in Black women in most cases?

One of the most aggressive patterns of breast cancer is a subtype commonly referred to as “triple negative breast cancer (TNBC)”. TNBC accounts for approximately 15% of all breast cancers that we see in the United States and in Europe; it is often more difficult to detect on routine mammograms; it tends to cause larger tumors compared to non-TNBC; and it is more likely to metastasize (spread) to other organ, such as the lungs and the brain, compared to non-TNBC cases. Because of its inherently aggressive nature, TNBC is more likely to require chemotherapy treatments compared to non-TNBC.


TNBC is twice as common in AA compared to WA women, accounting for approximately 30% of cases. This increased prevalence of TNBC in AA compared to WA also contributes to survival disparities.

It is also noteworthy that TNBC is more common among women who have inherited mutations in the BRCA1 gene; genetic counseling programs are therefore very important among AA women diagnosed with TNBC.

Breast Cancer Differences
by Race and Ethnicity

Some variations in breast cancer can be seen 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 have the highest death rate from breast cancer. This is thought to be partially because about 1 in 5 Black women with breast cancer have triple-negative breast cancer - more than any other racial/ethnic group.

 


These cancers tend to be more common in women younger than age 40 . . .

Black women have a higher chance of developing breast cancer before the age of 40 than white women.
At every age, Black women are more likely to die from breast cancer than any other race or ethnic group.

Triple-negative breast cancer (TNBC) accounts for about 10-15% of all breast cancers. The term triple-negative breast cancer refers to the fact that the cancer cells don’t have estrogen or progesterone receptors (ER or PR) and also don’t make any or too much of the protein called HER2. (The cells test "negative" on all 3 tests.) These cancers tend to be more common in women younger than age 40, who are Black, or who have a BRCA1 mutation.

TNBC differs from other types of invasive breast cancer in that it tends to grow and spread faster, has fewer treatment options, and tends to have a worse prognosis (outcome).

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