Researchers believe that about 5–10% of breast cancer cases are hereditary. Some research suggests that women of color may be just as likely to have hereditary breast cancer mutations as white women.

Some research suggests that women of color may be just as likely to have hereditary breast cancer mutations as white women. However, women of color tend not to undergo testing as frequently.

Use of the term women of color in this article refers broadly to non white women. When a study paper or another source uses different or more specific terms, such as Black women or African American women, we will also use that term.

Although genetic testing does not prevent breast cancer, it can help a person understand their potential risk and seek earlier screening and diagnosis, which may help improve outcomes. Genetic testing for people with an existing breast cancer diagnosis may also help improve treatments.

Sex and gender exist on spectrums. This article uses the term “women” when discussing people who are assigned female at birth to reflect language that appears in source materials.

More people search using the term “women,” so this is used throughout the piece to reflect that trend.

Learn more about the difference between sex and gender.

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Genetic testing for breast cancer involves checking a person’s body for the presence of genes that make their risk of developing breast cancer higher.

The two most common gene mutations that doctors test for are BRCA1 and BRCA2. However, they may also look for mutations in the following:

  • ATM
  • CHEK2
  • CDH1
  • PALB2
  • PTEN
  • STK11
  • TP53
  • PIK3CA

Testing for genetic mutations typically involves taking a sample of the person’s blood or saliva. The doctor will then send the sample to a laboratory. The laboratory will eventually return the results to the ordering doctor’s office.

According to the American Cancer Society, doctors tend to believe that white women are slightly more likely to develop breast cancer than African American women.

However, the gap in that statistic is closing because researchers are learning more about breast cancer in women of color.

They now know that African American women are more likely to:

  • develop breast cancer before the age of 40 years
  • die from breast cancer
  • develop more aggressive types of breast cancer, such as triple-negative breast cancer

The Black Women’s Health Imperative (BWHI) adds that African American women are more likely to receive a diagnosis of advanced stage breast cancer than white women. Their tumors are also more likely to grow and spread to other areas of the body.

BRCA1 and BRCA2

BRCA1 and BRCA2 are the most common genes associated with inherited breast cancer cases. The prevalence of irregularities in these genes is around 5% in women with breast cancer in the United States. However, this statistic is from research primarily focusing on testing in white women.

According to a 2015 study, Black women may have a higher rate of either BRCA1 or BRCA2 gene mutations than doctors previously thought. Around 12.4% of Black women with breast cancer tested positive for one or the other gene mutation.

A 2021 study also found that the prevalence of pathogenic mutations in BRCA2 was higher in Black women, but not significantly. They found the same when studying pathogenic mutations in CHEK2 and PALB2 genes.

HR+/HER2-

HR+/HER2- is a subtype of breast cancer also known as luminal A and luminal B. White women have the most new cases of HR+/HER2- breast cancer. This subtype affects around 87.2 per 100,000 women each year, according to the National Cancer Institute.

Black women have the second highest rate of new cases, affecting around 74.4 per 100,000 women each year.

HR-/HER2- or triple-negative

HR-/HER2- is a subtype that is also known as triple-negative breast cancer. It is one of the most aggressive forms of breast cancer. It is more likely to cause larger tumors and spread to other areas of the body.

According to the BWHI, rates of triple-negative breast cancer account for about 30% of cases in African American women. It is about two times more common in African American women than in white women.

The National Cancer Institute presents similar data, indicating that Black women experience higher rates of triple-negative breast cancer than any other ethnic group.

Genetic testing plays an important role in determining the risk of breast cancer.

It is important for doctors to educate and empower women of color about breast cancer risk and the importance of screening.

Those with risk factors such as known gene mutations or relatives who have had breast cancer can start getting mammograms earlier than other women.

Women of color can also watch out for unusual changes in their breasts, such as new lumps, discharge, and changes in skin color or inflammation.

Early detection is important in treating breast cancer. The detection of cancer in women of color is slower than in other groups, and doctors often diagnose more advanced stages of breast cancer in these women.

There are five main treatment options available to treat breast cancer:

  • surgery
  • chemotherapy
  • radiation therapy
  • hormone therapy
  • biological therapy and immunotherapy

A doctor may also make lifestyle recommendations — such as following a healthy diet, staying active, and focusing on mental health — as a part of treatment. The doctor may also determine if a person is a good candidate for a clinical trial.

Many factors can affect treatment decisions and outcomes. These include the stage of the cancer, the type of cancer, the size of the cancer, whether or not there is lymph node involvement, the person’s age, and their overall health.

The BWHI states that both genetics and socioeconomic reasons may play a role in worsened clinical outcomes for women of color.

In one 2016 study, researchers surveyed Black women in random public locations. They found that 88% of respondents were unaware of specific BRCA1 or BRCA2 testing, the most common testing for breast cancer gene mutations.

The researchers indicate that removing barriers to testing is necessary to help women of color undergo testing more frequently.

Black women are also less likely to receive genetic testing due to a lack of recommendations from surgeons or oncologists.

Breastcancer.org states that an individual can consider genetic testing if three or more women in their family had a breast cancer or ovarian cancer diagnosis, particularly if they received the diagnosis when they were younger than 50 years.

However, even if a person does not have three or more family members with a diagnosis, it is still important to contact a doctor about genetic testing if they have any concerns. Doctors may still recommend genetic testing in some cases.

If the person’s doctor does not recommend genetic testing, they may wish to get a second opinion by consulting another doctor or breast cancer specialist.

Genetics play a role in some cases of breast cancer. Doctors should educate and empower women of color to learn about their risk factors, including the prevalence of triple-negative breast cancer and the importance of receiving a diagnosis during the earlier stages.

Understanding these risk factors and seeking genetic testing can help women of color undergo proper screening to diagnose and treat breast cancer sooner, which may lead to better outcomes.