Breast cancer remains a leading health threat for women globally, with approximately 1 in 8 women diagnosed in their lifetime. However, as a physician who has witnessed the deep disparities in healthcare outcomes, it is crucial to address the alarming reality for Black women facing this disease. Despite a slightly lower incidence of breast cancer among Black women compared to White women, Black women are 40% more likely to die from the disease. The numbers are staggering, and the reasons behind this disparity are complex, ranging from genetics to systemic healthcare inequities.

As a medical professional, I feel a strong obligation to shed light on the unique challenges Black women face when it comes to breast cancer and offer guidance on steps that can be taken to reduce risk and improve outcomes.

• Higher Mortality Rates: While breast cancer may be less common in Black women, the mortality rate is significantly higher. This disparity is often due to later-stage diagnoses and more aggressive cancer subtypes.
• Aggressive Subtypes: Black women are more likely to be diagnosed with triple-negative breast cancer (TNBC), an aggressive form that does not respond to hormone therapies, making it harder to treat. Though TNBC accounts for only 10-15% of all breast cancer cases, 1 in 5 Black women diagnosed with breast cancer have this subtype.
• Younger Age at Diagnosis: Black women are also more likely to be diagnosed at a younger age. The median age of diagnosis for Black women is 59, compared to 63 for White women.
• Survival Rates: Black women have the lowest five-year relative breast cancer survival rate of any racial or ethnic group. Despite being less likely to be diagnosed with breast cancer than White women, they are 41% more likely to die from it.
• Delayed Screening and Treatment: Systemic inequities in healthcare, such as barriers related to insurance and financial resources, often result in delayed screenings and access to advanced treatments for Black women. This delay can severely impact survival rates, as early detection is key to better outcomes.

While breast cancer cannot always be prevented, there are several steps Black women can take to reduce their risk and improve their chances of early detection.

A family history of breast or ovarian cancer, particularly at a young age, can increase your risk. It is important to have a thorough discussion with your relatives and share this information with your doctor. Genetic counseling and earlier screening may be recommended based on your family history. For many Black women, this step is crucial, as family histories are often underreported.

Early detection can save lives. The United States Preventive Services Task Force recommends that women aged 40 to 74 receive a mammogram every two years. However, Black women—especially those with a family history or other risk factors—may need earlier or more frequent screenings. Women with dense breasts may also require additional imaging, such as ultrasound or MRI, alongside mammograms. Be sure to have an open dialogue with your healthcare provider about the best screening plan for you.

• Exercise: Engaging in at least 150 minutes of moderate physical activity per week can reduce your risk of breast cancer.
• Healthy Diet: A diet rich in fruits, vegetables, and whole grains while limiting processed foods and red meat can help lower breast cancer risk.
• Limit Alcohol: Studies show that regular alcohol consumption increases the risk of breast cancer, so limiting intake is advised.
• Maintain a Healthy Weight: Obesity, particularly in postmenopausal Black women, is associated with an increased risk of breast cancer.
• Avoid Smoking: Smoking is linked to several cancers, including breast cancer.

Establishing a strong relationship with a healthcare provider who understands your specific risk factors is essential. Many community programs offer free or low-cost screenings for uninsured or underinsured women, so it is important to explore those options if necessary.

Given the disparities in breast cancer outcomes, self-advocacy is critical. Here’s how you can be proactive about your health:

• Ask Questions: Be vocal with your healthcare provider about your risk factors, screening options, and potential treatment plans.
• Get a Second Opinion: If you have concerns or feel uncertain about a diagnosis, don’t hesitate to seek a second opinion.
• Stay Informed: Knowledge is power. Keep up with the latest research on breast cancer screening and treatments, and advocate for the best care possible.

Breast cancer is a pervasive health issue for all women, but Black women face unique challenges that often result in worse outcomes. Awareness, education, and proactive healthcare strategies are essential to bridging the gap in breast cancer disparities. By knowing your family history, engaging in regular screenings, and maintaining a healthy lifestyle, you can take meaningful steps toward reducing your risk and improving your chances of survival. Together, we can work toward a future where all women have equitable access to the care they need to thrive.