Breast cancer is the leading type of cancer affecting women worldwide. Around 1 in 8 women in the United States developing some form of breast cancer in their lifetime. Many of the risk factors that increase a person’s chance of getting breast cancer are out of their control, including genetics, family history, age, breast density, and race and ethnicity.
Although 10 percent of breast cancer cases are linked to genetics, race and ethnicity also play a role in a person’s breast cancer risk. This article will break down what the research says regarding race, ethnicity, and breast cancer; the types of breast cancer that are affected; and how health disparities and socioeconomic status can also be factors to consider.
White, non-Hispanic women living in the U.S. are more likely to develop breast cancer than women of color, but not by a large margin. When broken down statistically, white women in the U.S. have a 13-percent lifetime chance of a breast cancer diagnosis, while Black women are close behind with 12 percent. Asian Americans and Latinas both have an 11-percent breast cancer incidence rate. American Indian, Pacific Islander, and Alaska Native women in the U.S. have the lowest rate at 8 percent.
These data points illustrate a general picture of how race and ethnicity may affect a woman’s risk of breast cancer. However, a deeper dive into the research reveals a few important trends. Among them, data shows that in the U.S., Black women can be at a disadvantage compared to white women once they are diagnosed with breast cancer. These trends outline that African American women are at an increased risk of:
Trends among Asian American women may be starting to shift as well. One study, focused on the San Francisco Bay Area, found that women of Asian descent who were born in the U.S. may have a lower breast cancer incidence rate compared to Asian women who have immigrated to the U.S. Previous studies, however, had found Asian immigrants had lower rates of breast cancer compared to their U.S.-born counterparts. Racial and ethnic differences may be at play here. The differences also may be related to access to breast cancer screenings and more advanced health care resources.
Race and ethnicity may also play a part in what type of breast cancer a person may develop.
Triple-negative breast cancer is negative for estrogen receptor, progesterone receptor, and HER2. Triple-negative breast cancers often have high-grade, aggressive tumor characteristics. This cancer type is found in African American women at twice the rate as in white American women.
Notably, however, a study in Cancer found that the prevalence of triple-negative breast cancer varied in Black women depending on where they were born. According to the study, those born in West Africa had similar rates of triple-negative breast cancer as Black women born in the U.S. However, Black women born in the Caribbean had a 13 percent lower prevalence, and those born in East Africa had a 47 percent lower prevalence.
“It’s not clear what risk factors for developing breast cancer may be associated with birthplace. The differences could be due to genetics,” according to an analysis of the study from the American Cancer Society. “Most Black women born in the U.S. or in the Caribbean are likely descendants of people who were involuntarily migrated from West Africa to North America during the 16th to 18th centuries, often through the Caribbean. Ancestry studies among Black people living in Chicago, Baltimore, Pittsburgh, and North Carolina reflect the historic migration. Ancestry in those places is 71 percent Western Africa. The differences could also be due to risks from values, traditions, social structures, income, or health behaviors, such as eating a western diet.”
Scientists also have found that triple-negative breast cancer is more prevalent among Latina women compared to white women — and that genetic and biologic differences may contribute significantly to these differences. “Noticeable differences in breast cancer incidence are present even within different Latina subsets with a higher incidence in second- and third-generation women compared with foreign born,” according to a 2010 study from The Oncologist.
Another study highlighted the fact that traditions and health behaviors among different ethnic groups may contribute to a person’s chances of developing different types of cancer. For example, scientists have found that breastfeeding can decrease a person’s risk of developing triple-negative breast cancer. According to one study, African American women typically have a lower rate of breastfeeding when compared to white women in the U.S. This has led researchers to hypothesize that breastfeeding rates could be a cause for the disparity in breast cancer rates.
Active research is being conducted to find new therapies for triple-negative breast cancer through clinical trials. However, the African American population has historically been underrepresented in clinical trials taking place in the U.S. This could lead to an even larger gap in effective treatment and access to health care resources.
A difference in specific biomarkers and biological tumor properties between Black and white women may also be a cause of the racial disparities and breast cancer mortality rates. These possible differences in tumor traits can include:
The variation in these biological properties can influence treatment options, cancer survival rates, and early detection screenings among different racial groups.
Since breast cancer is highly hereditary, certain genetic mutations — specifically BRCA1 and BRCA2 gene mutations — can play a large role in which women will develop breast cancer in their lifetimes. According to research, race and ethnicity do play a factor in increasing a woman’s chance of having a gene mutation.
Researchers have found that Black and white women have the highest incidence of the BRCA1 and BRCA2 harmful gene mutations, with 18 percent and 16 percent, respectively. Asian and Hispanic Americans again have the lowest incidence rate, with 8 percent having a harmful gene mutation.
While white women are statistically diagnosed more frequently with breast cancer, Black women typically die from the disease at higher rates and are diagnosed at more advanced stage breast cancer. These differences are largely due to health disparities and socioeconomic factors creating public health and social justice issues.
Socioeconomic status has a large influence on breast cancer incidence in the U.S., creating wide gaps in access to health care, early detection mammography, late-stage diagnosis, timely follow-up, and breast cancer treatment options. People living in poverty and underserved communities have higher breast cancer mortality rates than those living in more affluent communities.
Health insurance and the high costs associated with accessing the health care system in the U.S. are major factors in how much access people have to medical providers. African Americans and Latina Americans historically have lower rates of health care coverage compared to non-Hispanic white people. This puts them at a disadvantage when it comes to being treated for life-threatening diseases.
Although you can’t change your race, ethnicity, or genetic make-up, you can take steps to help minimize your risk of developing breast cancer. Adopting a healthy lifestyle may be the best way to take charge of your body. These tips can help you take action and improve your quality of life:
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