Black women with breast cancer are at an increased risk for negative outcomes and reduced treatment efficacy. Timely, annual screenings can help close the racial disparity and improve prognosis.
Breast cancer presents a unique epidemiological risk to Black women. Black women are more likely to be diagnosed before age 40, and their mortality rates are 42% higher than those of White women, even after controlling for socioeconomic factors. Disparities in health and access to care disproportionately affect Black women in the U.S., and this may underlie the increasingly divergent outcomes.
Frequent breast cancer screenings increase the chances of identifying cancers early, leading to improved prognosis and survival rates. However, screening recommendations from professional organizations are not standardized, despite the known association between regular mammography and favorable outcomes. Black women are more often diagnosed at more advanced stages than White women, which could be due to less frequent screening.
Biological differences, such as tumor biology at diagnosis, determine how clinicians decide to treat patients. With Black women more often presenting with aggressive tumor subtypes, like triple-negative breast cancer and late-stage tumors, some hormone therapies are less likely to be effective. Genetic evidence also suggests that individual predispositions could decrease the efficacy of endocrine-based interventions.
The American Society of Breast Cancer Surgeons recommends an initial risk assessment at age 25 by reviewing family and personal health history with a physician. Women should then undergo annual mammograms starting at age 40. The Breast Cancer Risk Assessment Tool now incorporates race to more accurately estimate vulnerabilities given current health disparities, with the goal of decreasing the age at diagnosis. Closing the gap in breast cancer outcomes will require increased accessibility to screenings, providing education for providers and patients, and improving representation in clinical trials.
Source:
Fayanju, O. M., Edmonds, C. E., Reyes, S. A., Arciero, C., Bea, V. J., Crown, A., & Joseph, K. A. (2023). The Landmark Series-Addressing Disparities in Breast Cancer Screening: New Recommendations for Black Women. Ann Surg Oncol, 30(1), 58-67. https://doi.org/10.1245/s10434-022-12535-8
