6 Things All Black Women Need to Know About Breast Cancer

It’s not entirely understood why Black women are more at risk for these aggressive cancers, but there is likely a complex array of factors—both genetic and lifestyle—at play.

Complicating matters, triple negative breast cancer can be especially difficult to treat because it doesn’t have estrogen receptors, progesterone receptors, or human epidermal growth factor. Breast cancers that do have these receptors receive signals from different hormones that tell them to grow. “A lot of our advances in breast cancer treatment have been in designing drugs that actually go to those receptors and block those receptors,” Carmen Guerra, M.D., M.S.C.E., associate professor of medicine at the Perelman School of Medicine, University of Pennsylvania and volunteer leader and scientific officer for American Cancer Society National Board of Directors, tells SELF. That means TNBC, which already disproportionately affects Black women, is also much more difficult to treat because the science hasn’t caught up yet.

But there is research in the works, like the TARA study, which is being led by Dr. Torres. The aim: treating a specific type of metastatic TNBC using a combination of radiation, immunotherapy, and targeted therapy. Dr. Torres says the hope is to stimulate tumors to make them more responsive to immunotherapy, which helps your own body attack and destroy cancer cells, after exposure to radiation.

2. Many Black women don’t participate in clinical trials, often for reasons beyond their control.

Like many other things, you have to be in the room where it happens to enact or experience change. In the case of breast cancer, that “room” can include clinical trials where new and innovative treatments are being offered. Unfortunately, for a myriad of reasons, including mistrust of the medical community based on both past and present experiences, lack of access, and simply not being diagnosed, Black women often don’t participate in clinical trials.

In fact, from 1990 to 2010, between 80% and 90% of people with breast cancer who enrolled in practice-changing clinical trials were non-Hispanic white people⁵. This underrepresentation can hamper the proper development of treatments and understanding of their potential efficacy for Black women, who, as we mentioned, are already susceptible to breast cancers that are difficult to treat.

“When therapies in these studies significantly improve outcomes and survival, the first patients to benefit are often not minorities,” says Dr. Torres. “When these trials lead to changes in standard practice, the uptake of these treatments into everyday practice may be slow given differences in provider knowledge and difficulties with insurance coverage often encountered with new and expensive, but highly effective, therapies.”

To encourage more Black women to sign up for these trials—and actually increase access to these trials for those who are interested—Dr. Guerra says health care professionals have to leave the hospitals and go into the communities. Her research, which appears in a recent issue of the Journal of Clinical Oncology⁶ did just that. By focusing on things like developing more culturally tailored marketing, including brochures and websites that featured the Black community, partnering with faith-based entities as well as individuals that have received treatment to speak with community members, providing transportation, and including a minority participation plan for every single trial, Dr. Guerra and her team were able to double clinical trial participation rates at the Abramson Cancer Center in Philadelphia among Black cancer patients over a four-year period.

3. Black women tend to have denser breasts.

Having dense breasts means you have more glandular and fibrous connective tissue than fat. Dense breasts can be normal and are in fact pretty common! Nearly half of all women 40 and older who get mammograms have dense breasts. But it’s also worth noting that they can be a risk factor for breast cancer, according to the National Cancer Institute. Women with dense breasts are 1.2 times more likely to develop breast cancer than those with average breast density. What’s more, Black women typically have denser breasts than white women.^7,8 You can’t tell if you have dense breasts just by feel or firmness—a mammogram is the only way to know.

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