Black women are still dying from breast cancer at higher rates than white women — here's what experts want you to know

Black women are still dying from breast cancer at higher rates than white women — here's what experts want you to know

New breast cancer statistics show persistent racial disparities in mortality rates between black and white women. Unfortunately, this is just one example of the consequences of unequal health care in America. (Read more: Why the US urgently needs more black women doctors)

Although breast cancer is the most common cancer among women in the United States, breast cancer mortality rates have declined since their peak in 1989, according to a new report from the American Cancer Society (ACS) released October 3, 2022. Breast cancer mortality rates fell 43 percent between 1989 and 2020, which experts attribute to earlier detection through breast cancer screening, greater awareness of the disease and better treatment options.

Despite the fact that black women have a four percent lower incidence rate of breast cancer than white women, black women have a 40 percent higher mortality rate, the ACS reports. Additionally, the mortality rate for black women under 50 is twice as high as for white women in the same age group. (Note: Breast cancer primarily affects women aged 50 and over.)

Unfortunately, these numbers aren't exactly surprising. “We have been reporting the same discrepancy year after year for a decade,” said Rebecca Siegel, MPH, senior scientific director of ACS Cancer Surveillance and co-author of the study, in a recent article.

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“What's new [in the recent ACS report] just shows that this [racial disparity in breast cancer mortality rate] hasn't changed,” Eric Winer, MD, director of the Yale Cancer Center and chief medical officer of the Smillow Cancer Network, tells Shape. “And shows the extent to which the disparities exist, particularly among young black women,” he adds.

The overall decline in mortality rates among women diagnosed with breast cancer over the past 30 years is "encouraging," says Dr. Winer. "But I think that the - I would call it dramatic and unacceptable - inequality that exists for black women and particularly young black women is really sobering and frankly frightening."

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Why does this problem persist? “I think most of us believe that a lot of the challenge is providing care and ensuring that care is available to everyone and is delivered effectively,” he says. "And I think that for black women ... the care that they receive, unfortunately, is probably not equivalent to what white women receive."

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According to Dr. Winer says there are a number of factors that contribute to this unequal level of care and access. “It's because of socioeconomic disparities because we know that education and income and having health insurance versus not [having health insurance] play a role in the care that you receive,” he says.

“Part of this can of course also be attributed to the experience of systemic racism,” says Dr. Winer. "Racism has been shown to have very profound effects on health. And even if we fixed all social problems, there could still be a difference." For example, black women are statistically more likely to have diabetes, heart disease, and obesity, and they are less likely to breastfeed after giving birth. These are all risk factors for breast cancer, reports the Breast Cancer Research Foundation.

It's also important to note that while young black women are more likely to suffer from an aggressive type of cancer (called triple-negative breast cancer) than their white counterparts, that does not account for the racial mortality rate highlighted in the recent ACS article, according to experts. The new report shows a disparity in outcomes for patients with estrogen receptor-positive breast cancer, emphasizes Dr. Winer. “The differences in mortality rates are not explained by the fact that black women have more aggressive cancers,” Siegel added in the ACS article.

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“The better our treatment of breast cancer gets, the more unacceptable it is that these large disparities exist,” adds Dr. Winer added. “When you have diseases where there is a curative therapy, it's just tragic if someone doesn't get it.”

How to close the racial gap in breast cancer care

The entire healthcare industry is working to close the racial gap in breast cancer care. According to Dr. Winer, for example, there are new guidelines that require comprehensive cancer centers in the U.S. to focus on issues related to these disparities in order to receive grants. “So I think we’re taking steps forward at the national level,” he says. In addition, doctors need to not only be aware of these statistics, but also "make sure that black women with breast cancer receive the same treatment that they would give a white woman," he says.

While the health care community as a whole is aware of racial disparities in access to and care for women with breast cancer, there is clearly more work to be done. “It’s time for health systems to take a hard look at how they care for Black women differently,” Siegel said. And that seems to be exactly what Dr. Winer and his staff do.

“That's something that, as director of the cancer center here [at Yale], we're very focused on,” he says.

Given these statistics, Dr. Winer Black women to follow screening recommendations (the minimum age for breast cancer screening is 45), seek the best possible treatment if diagnosed with breast cancer, and adhere to the prescribed course of treatment if diagnosed. Of course, this is easier said than done, admits Dr. Winer one. “It's clearly very challenging for a lot of people,” he says, pointing to the aforementioned socioeconomic issues and systemic racism that contribute to Black women going undiagnosed and receiving the best possible care.