Why More Black Women Die from Metastatic Breast Cancer

According to a CDC report, Black women have higher death rates from cancer than any other group. With the lowest five-year survival rate, they are more likely than White people to be diagnosed with female breast, lung, and colorectal cancers at a late stage. And because Black women tend to be younger when they’re diagnosed with advanced or even metastatic breast cancer, “due to a combination of biological, socioeconomic, and systemic factors, they are more likely to develop aggressive subtypes like triple-negative breast cancer (TNC) and face barriers to timely healthcare access, including limited screening and treatment,” says Dr. Salhia Bodour, the interim chair of the department of translational genomics and Royce and Mary Trotter chair in cancer research at the Keck School of Medicine of USC.

Culturally, Black women may be reluctant to seek care, owing to their historical misuse as science experiments for gynecological advances, harvested stem cells without permission and sterilization practiced well into the 20th century. Mistrust leads to delayed diagnosis coupled with “healthcare system biases, and suboptimal care,” Dr. Bodour tells SheKnows. “Additionally, environmental exposures, lifestyle factors, and structural racism play significant roles in increasing risk and negatively affecting outcomes.” Unfortunately, these health disparities are costing Black women their lives.

Younger Ages at Diagnosis

Typically, breast cancer rates in women go up after age 50, with diagnosis in white women spiking between ages 60 to 84. Black women, on the other hand, are more likely to be diagnosed before age 45 compared to women of other races. The type of cancer will dictate treatment and it is imperative that if a knot, mass or lump is felt in the breast or underarm region, an appointment with a healthcare professional is made immediately.

Timing is everything when it comes to cancer. Antoinette Greer, co-founder and CEO of My Sister My Friend, Breast Cancer Support, a survivorship organization, run by survivors in Long Beach, California, learned this when she was 38 years old. Her mammogram detected a mass, but doctors told her it was a calcification and sent her home. Because her mother had breast cancer, she tells SheKnows, she should have advocated for that the fast-growing mass to be moved immediately. Instead, two years passed and Greer developed Stage 3B breast cancer, also known as locally advanced cancer, requiring a modified radical mastectomy, six months of chemotherapy, and twenty-six treatments of radiation.

After beating the odds, she started an affiliate chapter of the Houston, Texas-born Sister Network. “Black women are most comfortable in culturally competent spaces, and our organization offers resources, screening assistance, advocacy, and has presenters from the FDA, breast surgeons, fitness experts,” Greer explains. “We have women at all stages of their cancer journey so they can see where you have been or what’s on the horizon.” That means finding support for everything from the shock of diagnosis to the various griefs that treatment brings. Greer pointed out that losing hair to chemotherapy or radiation, for example, can be especially stressful and scary for a Black woman. First revered as her “crown and glory”, Black hair has been politicized and weaponized by family members, pop culture and the media to simultaneously uplift and demean Black women’s beauty.

Scientific Strides

While Greer is making a difference locally, the scientific community must use their expertise to save the lives of Black women, sooner rather than later. One way to make a difference is by including Black women in cancer research. According to the Journal of American Medical Association, only 2 percent of participants in oncology trials were Black women compared to 84 percent White women, which means that unique cultural and environmental experiences of Black women are not considered when formulating medicine or treatments.

It’s a huge miss, but one that experts are ready to rectify. The American Cancer Society, for example, launched VOICES of Black Women earlier this year, an initiative to obtain data about Black women’s bodies that will improve health outcomes for future generations. Open to Black women between the ages of 25-55 years old who do not have cancer, the goal is to study 100,000 women for the next 30 years to understand this demographic better.

“Fighting For Our Lives”

Another way to increase survivorship is self-advocacy. Dr. Mediget Teshome, chief of breast surgical oncology at UCLA, suggests women start with their primary care provider or gynecologist. “Share your family history about cancer anywhere in your family and consider taking an online risk assessment to get an idea if you are average or high risk,” she tells SheKnows. “This information helps with screenings. And, if your mammogram is normal but you have symptoms, ask for an evaluation.”

This is the path Miriam Ha, a physician assistant in Los Angeles, took in 2022, when her mammogram did not detect a lump in her breast that she herself could feel. She kept checking herself throughout the day but the small pinky-sized lump did not go away. A non-smoker with no first-degree relatives (parent, sibling or child) with cancer, she was told that she was low-risk. An ultrasound later revealed otherwise.

Ha, who had an HMO, was told it would be eight-weeks before she could see the surgeon, whose schedule was full. Unwilling to accept the delay in treatment, Ha reminded the scheduler that the HMO’s policy stated that 14-days from diagnosis was the timeline to implement a plan, which included an MRI to check for metastasis as well as actual surgery. Then, she encountered another delay because the MRI facility she was referred to was also booked.

“I insisted on being sent to one with a space and they found one,” she tells SheKnows. “I pushed because time was of the essence.” Ha made her HMO adhere to their medical treatment policy and ultimately underwent a bilateral mastectomy to decrease her anxiety about complications of reconstructive surgery as well as recurrence. Because removing breasts doesn’t remove the entire risk of cancer recurrence, she also made life changes like retiring from a stressful job, living a clean life, and eating foods high in antioxidants.

Now on the other side, Ha encourages other Black women to find their voices too. “We are literally fighting for our lives,” she says.

Treating Breast Cancer & Reducing Risk For Black Women

Treatment for breast cancer will vary. Not everyone will need a mastectomy, chemotherapy, and radiation or genetic testing. If you have the BRCA gene, a more aggressive form of treatment may be needed, such as a hysterectomy and bilateral mastectomy. Of equal importance is breast cancer in Black men. Dr. Teshome shares, “breast cancer affects men to a lesser degree than women, but Black men are diagnosed at higher rates than white men. Also, a male family member with breast cancer should prompt genetic testing.” She offers a couple of additional tips:

Other ways Black women can reduce breast cancer risk is through a healthy lifestyle:

More broadly, much needs to change to address the concerning trends in breast cancer when it comes to Black women. “Equitable access to quality healthcare, including screenings and advanced treatments, must be ensured,” Dr. Bodour says. “Addressing socioeconomic inequities and combating structural racism within healthcare are crucial for providing fair and unbiased care.” Community outreach, culturally sensitive education to promote earlier detection and healthcare-seeking behaviors, investing in targeted research, personalized medicine, and reducing harmful environmental exposures — all of these will play a role.

It won’t be easy, but ultimately, the tide can turn and disparities in breast cancer outcomes for Black women can be reduced.

Before you go, shop these gifts and products for breast cancer patients and survivors: