Black women are 40% more likely to die from breast cancer than white women, even though both are diagnosed at similar rates. This isn’t just a random, unlucky outcome—it’s a matter of racial disparities embedded in the healthcare system, not simply biology. A recent study published in the Journal of Clinical Oncology has shed some light on the troubling reality of why these differences persist.
The Study: Digging into the Data
In a meta-analysis covering 18 studies and nearly 230,000 breast cancer patients, including 34,000 Black women, researchers sought to understand if there was something inherently biological about why Black women had higher mortality rates. What they found, however, was eye-opening: the racial differences in breast cancer deaths aren’t predominantly due to more aggressive forms of cancer among Black women but stem from socioeconomic factors and structural inequalities in healthcare access.
“Within healthcare, there was this notion that an important contributor to disparities was that Black women have higher rates of triple-negative breast cancer,” says Dr. Erica Warner, a cancer epidemiologist at Massachusetts General Hospital and the study’s lead author. Triple-negative breast cancer is notoriously aggressive and difficult to treat, so it seemed logical to assume that Black women’s higher death rates were tied to this subtype. But the findings painted a different picture.
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Subtypes and Survival Rates: Breaking Down the Numbers
A tumor’s molecular subtype often determines how it behaves and how well it responds to treatment. In breast cancer, these subtypes depend on the receptors found on the tumor cell surface. For example, hormone receptor-positive (HR-positive) tumors have receptors for either estrogen or progesterone, while HER2-positive tumors have a receptor that helps the tumor spread faster.
For the most common subtype—HR-positive, HER2-negative—Black women were 50% more likely to die than white women. For HR-positive, HER2-positive breast cancer, Black women were 34% more likely to die. Surprisingly, even in cases of triple-negative breast cancer, which is known for its high mortality rates across the board, Black women still had a 17% higher chance of dying compared to their white counterparts .
Why the Disparities? It’s All About Access
These statistics raise a pressing question: why, even in treatable subtypes like HR-positive breast cancer, are Black women dying at disproportionately higher rates?
Dr. Eric Winer, director of the Yale Cancer Center, points to the cost of long-term treatments. Hormonal therapies, essential for treating HR-positive cancers, often need to be taken for five years or more. “Economics play a role,” says Winer. “People are falling through the cracks, whether that’s because they can’t afford hormone therapy or simply can’t pick up their medication.”
It’s not just about medication costs. Black women are also more likely to face barriers such as inadequate health insurance, transportation issues, and childcare concerns, making it harder for them to attend appointments and stick to treatment plans. These challenges, known as social determinants of health, significantly impact a person’s health outcomes. From food deserts to environmental pollutants, these factors shape the quality of life and healthcare access for many Black women .
Clinical Trials: A Missing Piece of the Puzzle
One often overlooked factor contributing to this disparity is the lack of Black women in clinical trials. Research studies that form the backbone of cancer treatments often don’t include enough Black participants, meaning that treatments may not be optimized for them. Dr. Wendy Wilcox, chief women’s health officer at New York City Health + Hospitals, points out, “From the very beginning, Black women are not being represented.” Without diverse participation in clinical trials, it’s harder to know if treatments will work as effectively across different racial groups .
Early Detection: A Life-Saving Step
Another key issue is early detection. Black women tend to develop breast cancer at younger ages, but screenings in the U.S. typically don’t start until age 40. “A lot of Black women can get breast cancer in their 30s,” says Dr. Marissa Howard-McNatt, director of the Breast Care Center at Atrium Health Wake Forest Baptist. She emphasizes the importance of knowing your family history. If someone in your family—say, a parent or sibling—was diagnosed with breast cancer at age 40, you should start screenings 10 years earlier than that.
What Needs to Change?
The racial disparity in breast cancer mortality rates didn’t always exist. Dr. Warner explains that 40 years ago, there was no significant gap between the survival rates of Black and white women. However, as breast cancer treatments have improved, Black women have been left behind. “That is problematic, but it also tells us we have our foot on the pedal for these differences. If we can create them, we can eliminate them,” she notes.
One promising solution is improving access to patient navigators, who help women—particularly those from underserved communities—understand their treatment options and arrange practical matters like transportation to medical appointments. Programs like this could help bridge the gap and provide Black women with the continuous care they need .
Bridging the Gap in Breast Cancer Treatment
The racial disparity in breast cancer deaths is more than just a statistic—it’s a public health crisis that demands attention. The solution isn’t simple, but it’s not impossible. By focusing on early detection, affordable long-term treatments, and better representation in clinical trials, the medical community can begin to close this deadly gap.
If you or someone you love is at risk for breast cancer, know your family history, advocate for early screening, and push for accessible, affordable healthcare options. It’s time to stop letting systemic inequality dictate who survives breast cancer.
Are you concerned about breast cancer risks? Don’t wait. Talk to your doctor about screening options, especially if breast cancer runs in your family. If you’re navigating a diagnosis, look into health centers with patient navigators who can help you through the process. Together, we can start closing the gap in breast cancer survival rates.
Sources
- Sullivan, K. (2024). “Black Women Are More Likely to Die from All Types of Breast Cancer.” NBC News.
- Journal of Clinical Oncology. (2024). “Racial Disparities in Breast Cancer Mortality: A Meta-Analysis.”
- Winer, E. et al. (2024). “Socioeconomic Factors in Breast Cancer Survival Rates.” Yale Cancer Center.
- Howard-McNatt, M. (2024). “Breast Cancer Screening for Black Women: Early Detection Strategies.” Atrium Health Wake Forest Baptist.
- Wilcox, W. (2024). “Black Women and Clinical Trials: A Critical Look.” New York City Health + Hospitals.
