Breast Cancer in Black Women

Medically Reviewed by Melinda Ratini, MS, DO on June 14, 2022
Written by Keri Wiginton
7 min read

For years, lung cancer has been the leading cause of cancer deaths in non-Hispanic Black women. That changed in 2019 – it’s now breast cancer. And there are racial disparities when it comes to early detection, mortality, and survival rates.

Talk to your doctor about your breast health. And start the conversation early. If you’re a Black woman, experts recommend discussing your breast cancer risk and plans for future screenings by age 30.

Breast cancer makes up 30% of all cancers found in women. About 12% of Black women get it during their lifetime. They have the second-highest rates of breast cancer compared to other races. Black women are also more likely to:

  • Get diagnosed with breast cancer before age 40
  • Have certain aggressive breast cancers
  • Have obesity and other health conditions
  • Get diagnosed with advanced (metastatic) breast cancer

Breast cancer rates have recently slowed and stabilized for Black women.

Black women can get any kind of breast cancer. But there are two kinds of fast-growing forms that happen more often in this group. That includes:

Inflammatory breast cancer. This is a rare but aggressive form of the disease. Black women who get it are more likely to be younger than 40 and have:

  • Other health problems
  • Advanced, or metastatic, disease
  • A low socioeconomic status
  • Worse overall and breast-cancer-specific survival rates

Triple-negative breast cancer (TNBC). Black women are two to three times more likely than white women to get this aggressive, hard-to-treat form of breast cancer. There’s ongoing research into why. But some things that raise the odds include:

TNBC isn’t driven by hormones, so it doesn’t respond to some common therapies. That means there are fewer treatment options. And compared to other breast cancers, it happens more often in Black women younger than 40, is less likely to be found early, and is more likely to come back.

Your outlook depends on how far the cancer has spread when you’re diagnosed.

The 5-year survival rate for all women who get TNBC is:

  • 91% for localized cancer that’s only in the breast
  • 65% for regional cancer that has spread to nearby areas
  • 12% for distant cancer that has spread to other parts of your body

This cancer is serious for anyone. But studies show Black women are 28% more likely to die from TNBC than white women are. Researchers think that’s partly because Black women are less likely to get surgery and chemotherapy.

Make sure your doctor follows the national treatment guidelines. The mainstay of treatment for TNBC is surgery, chemotherapy, and maybe radiation. If your doctor doesn’t suggest these to you, ask them why. You can also get a second opinion from another doctor.

Breast cancer is deadlier for Black women than for women of any other race or ethnicity. This is true of all age groups. Black women also survive the shortest length of time after diagnosis. They’re 41% more likely to die from breast cancer than white women.

Experts think higher rates of triple-negative breast cancer is a big factor. It’s more aggressive and has fewer treatment options. But there are other reasons for this racial disparity, including:

Structural racism. In general, Black people are less likely than white people to have access to health insurance or high-quality medical care. And black women are less likely to get breast cancer screenings at facilities with the most advanced imaging technology.

Experts blame disparities in health care largely on decades of racial discrimination and inequality.

If you’re a Black woman with breast cancer, racism roadblocks can make it so you’re:

  • Less likely to get timely treatment
  • Less likely to receive the right treatment
  • More likely to get diagnosed with advanced disease

While it’s clear that systemic racism negatively affects health, there is so much more research to be done. In the meantime, experts hope to find ways to address some of these barriers. Some examples are:

  • Including more Black women in breast cancer research
  • Addressing racial bias among health care professionals
  • Providing financial incentives for health systems that do well with mammogram screenings

Breast cancer is found later. Experts think death rates are higher among Black women partly because fewer cases are found early, or when it’s localized. Even so, Black women have reduced 5-year survival rates no matter when their breast cancer is diagnosed.

Medical mistrust. Black women with breast cancer are generally less trusting of the health care system. There are well-documented reasons for this.

Other health problems. Your genes and lifestyle affect your health. But public health experts think the ongoing stress of systemic racism and inequality can raise your cancer risk and worsen overall health.

Certain medical conditions affect Black women more often. Some that raise the odds of breast cancer include:

  • Diabetes
  • Heart disease
  • Obesity

Lack of breastfeeding after childbirth. There’s evidence that breastfeeding can lower the chances of certain kinds of breast cancer, but Black women are less likely to breastfeed their newborns. Experts recommend breastfeeding for at least a year, but that’s not something everyone can do. When it comes to triple-negative breast cancer, more research is needed to know if breastfeeding makes a difference.

Some people wonder if certain chemicals in  some hair and personal care products are tied to the disease. Product makers often use these chemicals, called parabens, as preservatives to keep mold and bacteria from growing. And a number of products marketed to Black women, like hair relaxers, have parabens in them.

Parabens can seep into your skin and have the potential to act like a much weaker form of estrogen, a female hormone your body makes. Estrogen can fuel the growth of some breast cancers.

For now, the FDA says it doesn’t have enough information to show that parabens in cosmetics affect people’s health. But the agency says it will keep reviewing safety studies on these chemicals.

Recent research on the topic is mixed.

A 2022 study presented at the Endocrine Society’s annual conference found that parabens caused harmful effects in breast cancer cells from Black women. The researchers tested cell cultures from Black women and others from white women in a lab. They found that parabens boosted the growth of a Black breast cancer cell line, but didn’t do the same for a line of white cancer cells. The chemicals also promoted the spread of breast cancer cells, and this effect was stronger in the Black cell line.

The researchers found that parabens increased the expression of genes linked to hormone action in breast cancer cells from both Black and white women. Gene expression is the process that turns on a gene in a cell to make proteins and RNA.    

Research presented at a conference usually hasn’t been published in a journal or peer-reviewed, so the results are considered preliminary.

Another 2022 study reviewed earlier research on whether parabens can raise the odds for breast cancer. That study’s authors concluded that it’s “debatable” whether there’s a direct link between parabens’ estrogen-like effects and normal breast cells turning cancerous. They said more research needs to be done.

These researchers recommended that people who have breast cancer or are at high risk for it be cautious about using personal-care products with parabens.

Parabens can be found in makeup, moisturizers, and shaving creams and gels as well as hair-care products. Some types of parabens you might see on labels are butylparaben, ethylparaben, methylparaben, and propylparaben.

Breast cancer affects everyone differently. But symptoms tend to be the same for all races.

Common symptoms include:

  • New lump or mass
  • Swelling in all or part of your breast
  • Skin that looks like an orange peel
  • Pain in your breast or nipple
  • Nipple changes or discharge
  • Swollen lymph nodes under your armpit or near the collarbone

Inflammatory breast cancer can look different from other kinds of breast cancer. Most symptoms develop fast, within 3 to 6 months. See your doctor right away if you get swelling and redness in your breast.

Certain tests can screen for breast cancer or predict your odds of getting it. Your doctor will go over the pros and cons of each one. Some they might suggest include:

Mammograms. This is a test that uses X-rays to take pictures of the inside of your breasts. Studies show it can prevent breast cancer deaths in women aged 40 or older.

The U.S. Preventive Services Task Force recommends annual mammograms for women ages 50 to 74.

Some groups suggest different screening guidelines if you’re a Black woman, including:

  • Assess your breast cancer risk by age 30
  • Get yearly mammograms starting at age 40
  • Continue screenings past age 74, unless you have life-limiting health issues

Genetic testing. About 5% to 10% of breast cancers are passed down through families. There's some evidence that the BRCA1 and BRCA2 mutations might happen more often in Black women.

A genetic counselor can tell you if these tests are right for you. They’re suggested if you have:

  • Family members who’ve had breast cancer
  • A personal history of breast cancer
  • Other family members who’ve tested positive for the BRCA1 or BRCA2 gene
  • Family members who’ve tested positive for other inherited breast cancer genes
  • You’re a Black woman who’s been diagnosed with breast cancer before age 35

Other tests. Tell your doctor if breast or ovarian cancer runs in your family. They might want to send you for genetic testing. The mammographer might want to take more detailed pictures of your breasts using an MRI or other imaging tests.

Keep in mind that breast cancer is never your fault. But you can take some healthy steps to lower your odds of health problems.

Lifestyle changes associated with lower rates of breast cancer include:

  • A diet high in non-starchy vegetables
  • Maintaining a healthy weight
  • Drinking less alcohol
  • Getting more physical activity
  • Avoiding some kinds of hormonal replacement therapy

It’s OK to get a second opinion from another breast cancer doctor. You can do this anytime you want, but especially if you feel your doctor isn’t taking your concerns seriously.

Some health resources and groups offer health support with Black women in mind. Some are geared toward those who’ve been diagnosed or treated for breast cancer. Others focus on general health issues that affect Black women and girls.

Some of those groups include:

  • African American Breast Cancer Alliance
  • Black Women’s Health Imperative
  • Sisters Network Inc.
  • Sisters by Choice