Breast cancer is the
For too many people, the color of their skin makes a difficult process even more challenging. Black women are more likely to be diagnosed with later stages of breast cancer and at a younger age. It’s unclear exactly why this is happening.
But there are likely multiple factors. Many Black women experience barriers to accessing healthcare.
This, along with a healthcare system that often doesn’t meet the needs of People of Color, makes it more likely that Black women will experience delays in getting follow-up care after an abnormal screening.
Black women are more likely to be diagnosed with a type of breast cancer known as
Many changes are needed to improve the care that Black women receive.
If you’re a Black person with metastatic breast cancer, there are some things you can do. There are also many things that need to change on a systemic level to improve cancer treatment in Black people.
Breast cancer is cancer that starts in the breast. When cancer cells from the breast spread to other parts of the body, it’s known as metastatic breast cancer.
Metastatic breast cancer is also known as stage 4 breast cancer. It’s an advanced stage of cancer. Breast cancer is
Treatment for metastatic breast cancer may include radiation, chemotherapy, or targeted therapies. In some cases, surgery is recommended.
Treatments may reduce symptoms and help people with metastatic cancer live longer.
The numbers of Black and white women diagnosed with breast cancer are similar. But when we look more closely, there are significant differences in the details.
Black women are
There are different types of breast cancer. After a diagnosis of breast cancer, cancer cells can be tested to find out more. Testing looks for estrogen or progesterone receptors and a protein called HER2. The results of testing can help guide treatment decisions.
One type of breast cancer is called triple-negative breast cancer (TNBC). This is when the cancer cells are negative in those other three tests.
Black women are
The average age of diagnosis in Black women is younger than in white women. Black women are more likely to develop breast cancer
The rates of breast cancer in white women are stable while rates
Dr. Teresa Hagan Thomas is an assistant professor at the University of Pittsburgh School of Nursing. She’s passionate about supporting women with advanced breast or gynecologic cancers to become their own advocates.
“The reasons [for disparities in breast cancer screening and treatment for Black women] are complex and still being uncovered by researchers and clinicians,” says Thomas.
“Many of the root issues deal with social determinants of health — including Black women’s higher likelihood of being un- or underinsured, the financial burden of cancer care, and transportation issues that impact their ability to get to and from their cancer clinic.”
When breast cancer is found early, there are more treatment options and better outcomes. Early detection requires regular screening with mammograms. A mammogram is a type of X-ray that shows pictures of the breast tissue to look for any changes.
Breast cancer rarely has any symptoms, so imaging is important to find cancer early. Routine mammograms can reduce death rates from breast cancer by up to
Income level and lack of health insurance are often barriers to getting a mammogram. In a survey of about 9,000 women,
“Access to free or discounted mammograms can help women be diagnosed earlier when the cancer is more treatable or even curable,” says Thomas.
Women with lower incomes are
Lack of access to quality healthcare can delay a diagnosis of breast cancer. Research shows that Black and other marginalized patients get less time with healthcare professionals.
Communication is worse between medical professionals and Patients of Color and the care is often of
The lack of trust in the healthcare system by many Black people in the United States is understandable and attributable to a long history and current practices.
A diagnosis of breast cancer can feel overwhelming. Thomas recommends doing your best to communicate with loved ones. “Stay connected to those who support you and let them help you when you need it.”
It may also be helpful to connect with organizations such as the Komen Foundation and local advocacy groups.
“Knowing that someone else has gone through what you are going through can be immensely helpful,” says Thomas. “You can learn from their experiences and also share your insight and suggestions.”
Learning as much as you can about your type of cancer and its treatment can help you feel more confident at appointments. Thomas recommends resources such as the American Cancer Society and The National Cancer Institute.
“This information can help you come prepared to understand the process and procedures,” says Thomas.
Thomas emphasizes the importance of solid relationships within your healthcare team.
“Building a strong relationship [with your healthcare professional] helps make sure they understand you, your concerns, and your priorities. Ask questions, make sure your concerns are addressed and ask for clarification if you don’t understand something they are saying.”
Medical appointments can be confusing, especially if you’re feeling overwhelmed. Consider bringing a friend or family member with you to appointments so you have extra support.
Thomas also notes that doing your best to follow a healthy lifestyle before and after a diagnosis is important. “Staying healthy, eating nutritious food, and getting physical activity can help prevent cancer and improve outcomes if a woman is diagnosed with cancer.”
Although there are things that individuals can do, it’s unfair to put it on Black women to fix this problem. There are deeper systemic issues that have created the disparities.
“We know that the care Black women receive needs to be improved,” says Thomas. “Black women report that their complaints of pain and symptoms are not taken seriously by their [doctors].”
We need to confront the following issues if we wish to ensure equal access and high quality care for everyone:
- Address medical mistrust: There are reasons why racialized patients are not always comfortable seeking healthcare. All healthcare professionals need to be aware of the barriers that patients may face and work to make care more accessible for all.
- Greater diversity in healthcare: Black people are underrepresented in healthcare professions. Changes need to happen at
all levelsof education to support more Black people to enter careers in healthcare.
- Improve access to health insurance: Although improvements have been made, there are still many people who are underinsured. The cost of healthcare can prevent people from getting the care they need.
There’s an association between breastfeeding and lower rates of triple-negative breast cancer. Black women in the United States have
There are several factors that influence breastfeeding rates. Lack of breastfeeding support is a major issue in many Black communities.
Studies also show that Black babies are
Some ways to better support Black mothers to breastfeed include:
- peer support groups before and after birth
- breastfeeding support and education in hospital
- check-ins with breastfeeding experts at postpartum appointments
Black women are diagnosed with metastatic breast cancer at higher rates compared to other groups. There are many factors that contribute to these numbers.
There are disparities in income and insurance that make early detection of breast cancer less likely. Early detection of breast cancer improves survival.
Racism is present in healthcare and may prevent people from getting the care they need. There are things that Black women can do to advocate for themselves.
“Being your own self-advocate is a hard thing to do when you are going through treatment and overwhelmed by the physical and emotional impacts of cancer,” says Thomas.
“The main goal is to make sure your values, needs, and priorities are clear to you and those that support you. When you have an issue or concern, make sure your team is behind you, making sure you get high quality care.”