As many of you know, October is breast cancer awareness month. And while strides are made every day in research, detection, and treatment, there are still too many women and men dying from this disease every year. Breast cancer is the second leading cause of cancer death among women in the United States and the first leading cause of cancer death globally. However, for black women, the stats are even more disturbing. While the rates of occurrence are similar in whites and blacks, black females die at a 40% higher rate than white females. BCT Partners explores three reasons why black women are more likely to die from the disease and necessary actions that should be taken to reverse this terrible trend.
1. One reason behind differences in breast cancer fatalities may be that prevalence rates of some risk factors for breast cancer vary by race and ethnic group. Some factors include age of first period, age of first childbirth, body weight, breastfeeding, number of childbirths and age of menopause. For example, black women have a lower breastfeeding rate and breastfeeding has been shown to lower the risk of breast cancer, especially in premenopausal women.
2. Another contributing factor may be that black women often get screened at public institutions, which may not have the same quality of equipment or dedicated breast imaging specialists reading the films. Research also shows that the time between a suspicious scan and follow-up is longer for black women versus white women, as is the time from diagnosis to treatment. For example, one study showed the average time from diagnosis to treatment was nearly 30 days for black women versus about 22 days for whites. With aggressive forms of cancer, each day without treatment can be the difference between life and death.
3. Finally, black women have a higher rate of being diagnosed with triple-negative breast cancer, which is often more aggressive and comes back after treatment. Triple-negative breast cancer gets its' name because the tumor tests negative for estrogen receptors, progesterone receptors, and excess HER2 protein. Therefore, it cannot be treated with hormonal therapy medications or medicines that target HER2 protein resulting in fewer treatment options. Additionally , triple-negative breast cancer tends to be higher grade meaning that less of the cancer cells resemble normal, healthy breast cells in appearance and growth, making it more likely to spread beyond the breast.
So, what can be done to ensure that fewer black women die from this deadly disease? There are some actions that women can start initiating and systemic changes that need to be made as well. For example, Sisters Network encourages black women to start taking action of their own and increasing awareness among women in the black community. They state on their website that, “while 92% of black women agree breast health is important, only 25% have recently discussed breast health with their family, friends, or colleagues. And, only 17% have taken steps to understand their risk for breast cancer.”
Secondly, there are products marketed to and used frequently by black women that could be contributing to the seriousness of their cancer. They include skin lighteners, hair relaxers, Brazilian blowout treatments, and acrylic nails. These products all contain some of the most toxic ingredients in cosmetics. Women should check for certain chemicals including mercury and formaldehyde and avoid products that contain them as much as possible. Luckily, some states are now taking action, with California being the first state to ban cosmetics that include these harmful ingredients. Unfortunately, the U.S. is way behind much of the rest of the world as 40 countries already have stricter cosmetic regulations.
Finally, systemic changes are necessary to ensure black women have access to accurate information, proper screening, and more treatment options. Another new initiative announced in California aims to be a blueprint for action using a social justice lens. It identifies and addresses 23 breast cancer risk factors such as toxic chemicals, workplace exposures, structural barriers to a healthy diet and physical activity, and the impact of racism and poverty.
As Janette Robinson Flint, Executive Director of Black Women for Wellness, states, "Although Black women die at some of the highest rates from breast cancer, there is rarely a justice-centered approach to tackling the issues that contribute to the morbidity and mortality of breast cancer. However, this new initiative is working to look upstream and tackle how issues such as environmental factors like toxic chemicals in our beauty and personal care products as well as historic racism are inexorable factors in working to end breast cancer.”