Breast cancer is one of the most common forms of cancer among females in the United States, second only to skin cancer.

In total, 1 in 8 females in the United States will develop breast cancer, but certain groups are more at risk. For instance, doctors most commonly diagnose breast cancer in non-Hispanic white and Black American individuals.

Earlier detection and better treatment options have made breast cancer an increasingly survivable disease. From 2012 to 2018, more than 90% of females with breast cancer survived for at least 5 years after receiving their diagnosis.

However, disparities exist in survival rates, as well. Non-Hispanic Black females are more likely to die from breast cancer than females belonging to any other racial or ethnic group. They are also more likely to receive a diagnosis of metastatic breast cancer than white or Asian/Pacific Islander females.

In this article, we examine some common questions about breast cancer in Black people, including some of the possible causes of the disparities in disease outcomes.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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With the exception of white females, Black females are more likely to receive a breast cancer diagnosis than those belonging to other racial or ethnic groups. In the United States, the rate of new cases per 100,000 people is:

  • 137.6 for non-Hispanic white females
  • 129.6 for non-Hispanic Black females
  • 111.3 for non-Hispanic American Indian or Alaskan Native females
  • 106.9 for non-Hispanic Asian or Pacific Island females
  • 99.9 for Hispanic females

The relatively high prevalence of breast cancer among Black females is likely related to a combination of biological and social factors.

For instance, in a 2019 study involving more than 1,500 females who received a breast cancer diagnosis at 50 years of age or younger, the researchers identified certain genetic mutations — those known to play a role in breast cancer development — more frequently in Black females than in any other group.

Black females are also more likely to have underlying health conditions that increase the likelihood of breast cancer, including:

  • diabetes
  • heart disease
  • obesity

Social and behavioral factors may play a role, as well. A growing body of research suggests, for example, that breastfeeding plays a role in breast cancer prevention.

According to the Centers for Disease Control and Prevention (CDC), which analyzed data from more than 3.1 million births in the United States in 2019, Black mothers report the lowest rates of breastfeeding initiation among all recorded racial and ethnic groups.

A number of factors may affect the decision or ability to breastfeed, and some of these factors may disproportionately affect Black females. Examples include a lack of support from the healthcare team and a lack of breastfeeding support in the workplace. A person may be subject to:

  • shorter maternity leaves
  • inflexible work hours
  • insufficient break times

The symptoms of breast cancer are similar in all females and can include:

  • a new lump in the breast or armpit
  • swelling of the breast
  • dimpling of the skin on the breast
  • breast or nipple pain
  • discoloration or flaky skin around the nipple
  • nipple retraction, which means that the nipple is pulling inward
  • nipple discharge, other than breast milk

Black females tend to get a breast cancer diagnosis at a younger age. The symptoms tend to be more severe and the disease more advanced at the point of diagnosis, so early detection is particularly important.

In a 2018 study involving nearly 47,000 females, moderate and frequent use of beauty and skin care products were associated with an increased risk of breast cancer — 13% and 15%, respectively — in white females. The small number of Black females in the trial meant that the researchers were unable to identify similar associations in this group. However, Black females may also wish to consider cancer risk when applying certain beauty products.

According to the MD Anderson Cancer Center, people should exercise caution when using hair straightening or smoothing products, which may contain formaldehyde. Certain bath and body care products, such as soaps or lotions, may also contain cancer-causing ingredients or chemicals that disrupt hormone signaling in the body. These types of ingredients include:

  • polyethylene glycol, or PEG
  • polyethylene
  • polyoxyethylene
  • chemical ending in -eth or -oxynol
  • phthalates
  • parabens

A combination of biological and social factors likely drives ethnic and racial disparities in both the initial risk of cancer and breast cancer outcomes.

Black females are more likely than those belonging to other racial and ethnic groups to get triple-negative breast cancer. This fast-growing form of breast cancer has fewer treatment options and tends to be associated with less positive outcomes.

Certain diseases that can occur alongside breast cancer, including vascular disease, obesity, and kidney disease, may also make it more difficult to treat. These conditions also disproportionately affect Black people.

As Black females tend to develop breast cancer at a younger age, they may not receive a diagnosis until a later stage of the disease. The reason for this is that current screening recommendations are age-based. Breast cancer will likely be more difficult to treat when doctors detect it at a later stage.

Experts suggest that lowering the recommended screening age for Black females may help reduce disparities in breast cancer outcomes.

Doctors can use the results of genetic testing to personalize treatment. Black females with breast cancer are less likely to undergo this testing, and this may affect their outlook.

Other social determinants of health that broadly affect health outcomes can also play a role, including:

  • access to healthcare
  • health insurance coverage
  • healthcare discrimination
  • healthy physical, emotional, and social environments

Black females are more likely to receive a diagnosis of breast cancer at a later stage when it has already metastasized to other parts of the body. With appropriate access to treatment, the 5-year relative survival rate for metastatic breast cancer is approximately 30%.

However, disparities in diagnosis, testing, and treatment may negatively affect the outlook for Black females with breast cancer.

Black females are among those whom breast cancer most commonly affects. However, due to a combination of biological and social factors, they are less likely to receive appropriate treatment early in the disease than females belonging to other racial or ethnic groups. This can lead to less positive outcomes.

Early screening and personal advocacy may help reduce ethnic and racial disparities in breast cancer outcomes.