New Cases

 

Breast cancer is the most commonly diagnosed cancer among black women, and an estimated 30,700 new cases are expected to be diagnosed in 2016. Similar to the pattern among white women, breast cancer incidence rates among black women increased rapidly during much of the 1980s (Figure 6a, page 13), largely due to increased detection by mammography screening. However, while rates thereafter generally stabilized in white women they continued to increase, albeit more slowly, in black women (0.5% per year from 1986 to 2012).4 As a result, incidence rates in black and white women converged in 2012.  The continued increase in incidence rates in black women may in part reflect the rising prevalence of obesity in this group (Figure 9).

 

During 2008-2012, the overall breast cancer incidence rate in black women was 124.3 cases per 100,000 women, 3% lower than in white women (128.1). However, rates were higher in black than in white women in seven US states (Alabama, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, and Tennessee), and were not significantly different in 24 states.26 Breast cancer incidence rates are also higher among blacks than whites for women under age 45. The median age of diagnosis is 58 for black women, compared to 62 for white women.

 

 

All women can help reduce their risk of breast cancer by avoiding weight gain and obesity (for postmenopausal breast cancer), engaging in regular physical activity, and minimizing alcohol intake. Women should consider the increased risk of breast can- cer associated with combined estrogen and progestin hormone therapy use when evaluating treatment options for menopausal symptoms. In addition, recent research indicates that long-term, heavy smoking may also increase breast cancer risk, particularly among women who start smoking before their first pregnancy.  More information about breast cancer is available in the American Cancer Society publication Breast Cancer Facts & Figures, available online at  www.cancer.org.

 

 *ACS African American 2016-2018 Cancer Facts

Survival

 

The overall 5-year relative survival rate for breast cancer diagnosed in 2005-2011 was 80% for black women compared to 91% for white women (Figure 5, page 11). This difference can be attributed to both later stage at detection and poorer stage-specific survival among black women. Only about half (52%) of breast cancers in black women are diagnosed at a local stage, compared to 63% in white women (Figure 4, page 10).

 

Later stage at diagnosis among black women has been largely attributed to lower frequency of and longer intervals between mammograms, and lack of timely follow-up of abnormal results.  Lower stage-specific survival has been explained in part by unequal access to and receipt of prompt, high-quality treatment among black women compared to white women. There is also evidence that aggressive tumor characteristics are more common in breast cancers diagnosed in black women than other racial/ethnic groups.26, 46-48 For example, 22% of breast cancers in black women are referred to as triple negative (ER-, PR-, and HER2) compared to 10-12% of those among women of other races/ethnicities in the US.26 These proportions are even higher among premenopausal black breast cancer patients.49 Triple negative breast cancers are more aggressive and have poorer prognosis, in part because there are currently no targeted therapies for these tumors.

 

Some studies suggest black women are more likely to be diagnosed with triple negative breast cancer as a result of African ancestry, while others find the cause to be related more to certain behavioral risk factors, such as reproductive patterns that are relatively more common in black women (including giving birth to more than one child, early age at first pregnancy, and lower rates of breastfeeding).  Visit cancer.org for additional information about breast cancer in the latest edition of Breast Cancer Facts & Figures.

 

 *ACS African American 2016-2018 Cancer Facts

 

 

Deaths

 

Breast cancer is the second most common cause of cancer death among black women, surpassed only by lung cancer. An estimated 6,310 deaths from breast cancer are expected to occur among black women in 2016. Breast cancer death rates among black women increased from 1975 to 1991, but declined thereafter as a result of improvements in both early detection and treatment. Prior to the mid-1980s, breast cancer death rates for white and black women were similar. However, a larger increase in black women from the mid-1970s to the early 1990s, followed by a slower decline, has resulted in a widening disparity. Since 1990, breast cancer death rates dropped 23% in black women compared to a 37% drop in white women (Figure 3, page 7). As a result, breast cancer death rates in the most recent time period (2008-2012) are 42% higher in black women compared to white women, despite similar incidence rates. Higher death rates among black women likely reflects a combination of factors, including differences in stage at diagnosis, obesity and comorbidities, and tumor characteristics, as well as access, adherence, and response to high-quality cancer treatment.

 

 

 *ACS African American 2016-2018 Cancer Facts