Breast cancer is a malignant tumor that starts in the cells of the breast. A malignant tumor is a group of cancer cells that can grow into (invade) surrounding tissues or spread (metastasize) to distant areas of the body. The disease occurs almost entirely in women, but men can get it, too.
Why is This Important For Black Women? Most women who get breast cancer have no known risk factors besides age. Many women with one or more risk factors never get breast cancer. So it's impossible to know who will actually get breast cancer. Factors that affect a woman's risk of breast cancer include:
- Age. The strongest risk factor is age. Risk goes up as a woman gets older. Most women who get breast cancer are older than 50.
- Personal history of breast cancer. Women who have had breast cancer in one breast are more likely to get it in the other breast.
- Family history. Having a mother, sister, or daughter who has had breast cancer increases a woman's risk. The risk is higher if her family member got breast cancer before age 40. A woman’s risk also is increased if more than one family member on either her mother’s or father’s side of the family has had breast cancer.
- Inheriting certain harmful gene mutations. A woman known to carry a harmful gene mutation should talk to her doctor about ways to try to lower her breast cancer risk or find breast cancer early.Here are some key points about genes and breast cancer:
- Inheriting changes to certain genes, such as BRCA1 and BRCA2, greatly increases the risk of breast cancer.
- Inherited genetic changes account for about 10 percent of all breast cancers.
- If you have a relative who has a harmful gene mutation, you may want to talk to a genetic counselor to learn more about your personal risk. You may also want to seek genetic counseling if your family history of cancer suggests a gene mutation.
- Certain breast changes that are not cancer. Women who have certain types of abnormal breast changes, such as atypical hyperplasia, ductal carcinoma in situ, and lobular carcinoma in situ, have a higher risk. These changes are found during a breast biopsy.
- Breast tissue that is dense on mammogram. Women whose breasts have more dense tissue relative to fatty tissue have a higher risk than women of about the same age who have little or no dense breast tissue.
- Menstrual and reproductive history. Getting your first menstrual period before age 12 increases breast cancer risk. Reaching menopause after age 55 increases breast cancer risk. Never having children or having children after age 30 also increases risk. Women who have a first baby before age 20 have a lower risk.
- Taking the hormones estrogen and progestin. Using menopausal hormone therapy containing both estrogen and progestin for more than five years increases breast cancer risk. It's not clear whether estrogen-only therapy affects risk. Using birth control pills may slightly increase the risk of breast cancer in current users, but this risk returns to normal over time.
- Radiation therapy to the chest. Radiation therapy to the chest for the treatment of cancer increases breast cancer risk. Risk depends on the dose of radiation and age of treatment. The risk is highest for radiation treatment used during puberty.
- Body weight. The chance of getting breast cancer after menopause is higher in women who are overweight or obese.
- Drinking alcohol. The more alcohol a woman drinks, the greater her risk of breast cancer.
- Taking DES. The drug DES, or diethylstilbestrol (dye-ETH-uhl-stil-BES-trol), was given to some pregnant women in the United States between about 1940 and 1971 to prevent miscarriage. (It is no longer given to pregnant women.) Women who took DES during pregnancy may have a slightly increased risk of breast cancer.
- Physical activity. Women who are not physically active throughout life may have an increased risk of breast cancer. Strenuous exercise for more than four hours per week may help lower breast cancer risk. Also, being active can help women prevent overweight and obesity, which are known risk factors for breast cancer in women who have reached menopause.
- Breastfeeding. Women who breastfeed have a lower risk of breast cancer.
Breast cancer is the most common form of cancer among Black women and the second leading cause of death for Black women. In 2010, the CDC reported that breast cancer was the leading cause of cancer death for Black women aged 45-64 years. In addition, the CDC reported that the breast cancer death rate for women aged 45-64 years was 60% higher for Black women than white women (56.8 and 35.6 deaths per 100,000, respectively).
(CDC: National Vital Statistics System: http://www.cdc.gov/nchs/nvss.htm)
Breast cancer is more common among women later in life, but can strike at any age. In fact, many are surprised to learn that young Black women have a higher risk of developing breast cancer.
Black women under age 40 have a higher incidence of breast cancer and lower survival rates than white women. One reason for these inequities is the differences in the types of breast cancer that affect Black women. Black women are often diagnosed at later stages when the cancer has already spread. The good news is when breast cancer is detected and treated early, Black women have a much greater chance of survival.
There is no known way to prevent breast cancer, but early detection and timely treatment can save lives. Breast cancer should not steal your future, especially during the prime of your life.
Early detection is critically important, especially for women at higher risk. For Black women who have been diagnosed at the earliest stage of breast cancer when the tumor is small and localized, early diagnosis can make a difference.
For most of us, early detection and diagnosis are attainable with a few easy steps:
- Have your provider show you how to perform monthly breast self-examination (BSE) and perform it faithfully at the same time each month.
- See your provider for a clinical breast examination (CBE) at least once a year.
- Have regular mammograms. Since breast density is one of the strongest risk factors for Black women developing breast cancer, insist on digital mammography or some of the newer more advanced technologies that help detect tumors
- Join our campaign to end breast cancer inequities, Moving Beyond Pink and sign up to become an advocate in your organization and community.
What the Imperative is doing
At the Black Women’s Health Imperative, we know that Black women have not benefited from the advances in breast cancer research and new technologies. It is our mission to raise questions, seek understanding, and call attention to what is happening with Black women.
Through our advocacy, policy and national and community-based initiatives, we are working to make eliminating breast cancer inequities among young Black women a public health priority. We do this by:
Educating women on the importance of early detection and timely diagnosis
Promoting routine breast self-exams (BSE), clinical breast exams (CBE) and mammograms.
Advocating for screening guidelines that are responsive to the health and needs of Black women
Advocating for increased access to the latest screening tools and improved diagnosis and treatment services
Advocating and supporting policies and practices that call for early education and screening among younger women.