Women of color have the highest breast cancer mortality rate and are more likely to receive a diagnosis of advanced-stage breast cancer than white women.

A Black woman with breast cancer looks into the distanceShare on Pinterest
FatCamera/Getty Images

According to the Black Women’s Health Imperative (BWHI), Black women are more likely to receive a diagnosis of metastatic breast cancer, be younger at diagnosis, and have more fatal outcomes than white women.

This article highlights some things that women of color should know about metastatic breast cancer.

The 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.

Metastatic breast cancer, or stage IV breast cancer, means that cancer has spread from the breasts to other areas of the body.

It most often spreads to:

  • the lungs
  • the brain
  • the liver
  • the bones

Cancer reaches other parts of the body through the blood and lymphatic system. As a result, cancer can develop in other areas of the body months or even years after the initial diagnosis of breast cancer.

About 30% of all women diagnosed with early-stage breast cancer will develop cancer in other areas of their bodies.

New cases and death rates of metastatic breast cancer do not occur evenly across races. According to the Centers for Disease Control and Prevention (CDC) and the National Center for Health Statistics (NCHS), Black women have the highest death rate due to breast cancer.

This may partly be due to the stage they receive their diagnosis. According to the BWHI, African American women are more likely to receive a cancer diagnosis at a more advanced stage than white women.

Research indicates that regardless of race, breast cancer is the most diagnosed form of cancer among women. The primary difference between breast cancer in women of color and white women is that women of color are more likely to receive diagnoses at later stages and have higher death rates due to cancer.

The following are some factors that affect the rate of metastatic breast cancer in women of color.

Early screening

The BWHI stresses the importance of breast cancer education for early detection. They emphasize that women with risk factors, such as having gene mutations or a family history of breast cancer, start getting mammograms about 5 to 10 years earlier than other women.

Genetic risk factors

BRCA1 and BRCA2 are two of the most common genes associated with inherited breast cancer cases. Some sources say these gene mutations are present in about 5-10% of those living with breast cancer, whereas others say it may be as low as 3%. However, these statistics derive from research carried out on non-Hispanic white women.

A 2015 study on Black women living in Florida identified that they had more BRCA1 or BRCA2 genes than non-Hispanic white women than scientists previously thought. The results showed that about 12% of Black women living with invasive breast cancer tested positive for one of these gene mutations.

Women of color can talk with their doctor about undergoing genetic screening.

Socioeconomic differences

Women of color may experience higher rates of metastatic breast cancer due to socioeconomic differences. According to the BWHI, African American women are more likely to experience delays in diagnosing and treating breast cancer.

One study cited ethical reasons for not addressing individual risk in lower income areas. The researchers interviewed several African American and Latina women who lived in these areas and had just found out they had an increased risk of developing breast cancer. They aimed to determine if increasing knowledge of individual risk would help decrease the mortality rate.

Their findings indicate that implementing individual risk assessments may help women from underserved communities get screened and treated sooner, reducing mortality risk.

Several factors affect breast cancer treatment outcomes, including:

  • type of breast cancer
  • size of the cancer
  • stage the cancer was found
  • hormone-receptor status of the cancer
  • HER2 status
  • rate of cell growth
  • new case vs. recurrence
  • likelihood of recurrence
  • age
  • menopausal status
  • overall health

Early detection is essential in breast cancer treatment. Women of color do not receive breast cancer diagnoses as early as other groups and are more likely to have more advanced stages of breast cancer.

Many factors can affect treatment decisions and outcomes. However, scientists think that the biology of the disease plays the most significant role in dictating the outcome.

There is no cure for metastatic breast cancer. Someone with this disease will need treatment for the remainder of their life. A person and their doctor can determine the best treatment options. They can make changes as necessary to manage the disease and maintain as high a quality of life as possible for the months or years following the diagnosis.

Not all doctors are up to date on the latest treatment options and information regarding metastatic breast cancer.

Findings from interviews and focus groups with a small group of middle-class Black women found that they often felt like their doctors did not always listen to them. As a result, many were reluctant to participate in their care and ask questions about their diagnosis and treatment options.

Findings from a 2022 study found high levels of perceived discrimination experienced by a small sample of Black women in a medical setting. From the women concerned, 48% felt health professionals treated them with less courtesy, and 42% were treated with less respect ‘most of the time.’ The study also showed that 21% of women felt they were ‘always’ not listened to.

It is important to find a provider who listens and values what a person has to say, especially when treating metastatic breast cancer.

One breast cancer charity suggests that a person consider the following factors when picking a team of specialists to treat their metastatic breast cancer:

  • Do the doctors communicate well, listen to you, and take your concerns seriously?
  • Are the doctor’s office staff helpful, accessible, and responsive to your calls?
  • Don’t hesitate to get a second opinion if you lack confidence in a particular doctor’s treatment recommendations, expertise, or communication skills.

A person can also seek out a second opinion as needed. A second opinion can help a person feel more comfortable and better understand the treatment process.

Finding the right doctor can be particularly difficult if insurance or monetary issues are a concern. The CDC offers several suggestions for managing costs, including:

  • understanding insurance policies
  • asking for generic drugs and discount prescription plans
  • asking about payment plans
  • questioning anything on the bill that does not make sense
  • learning what to expect in terms of cost

The CDC also offers links to several resources that a person may find useful if they do not have insurance or cannot afford the costs of cancer care.

Below are some commonly asked questions about metastatic breast cancer and women of color.

Which female group has the highest rate of breast cancer?

According to the CDC, white non-Hispanic women have the highest rate of breast cancer cases. However, the BWHI reports that African American women are more likely to receive a cancer diagnosis at a more advanced stage than white women.

What is the most common cancer in Black women?

Black women are most likely to be diagnosed with stomach, liver, or pancreatic cancer.

Is there a breast cancer foundation for women of color?

Here are some breast cancer organizations that support women of color:

Women of color have the highest breast cancer mortality rate and are more likely to receive a diagnosis of advanced-stage breast cancer than white women.

Education about risk and promoting early detection and treatment can help empower women of color to take charge of their health and improve their breast cancer outcomes.