For years, it has been known that Ashkenazi Jewish women have a higher risk for BRCA1 and BRCA2 gene mutations, and because of this, are at a higher risk for breast cancer than women of other ethnic backgrounds.
New evidence presented this year has also demonstrated a higher risk among African American women. According to statistics released this year by the American Cancer Society:
African-American women are 42% more likely to die from breast cancer than non-Hispanic white women—despite roughly equal incident rates
African-American women have a 2X greater risk of more aggressive “triple negative” breast tumors
African-American women are less likely to be diagnosed with stage 1 breast cancer, but twice as likely to die from early breast cancers
African-American women have a higher risk of BRCA1 and BRCA2 genetic mutations than those of Western Europe ancestry. These are gene mutations that carry a much higher risk for breast cancer.
Some of you reading this may wonder why it is that breast cancer affects African American women in this way. Are they less likely to get mammograms? Not according to the Centers for Disease Control and Prevention (CDC). In 2015, 69.8% of black women over 40 reported having a mammogram within the last 2 years, compared with 65.3% of white women, 60.9% of Hispanic women and 59.7% of Asian women.
Do African American Women—as a population—not have the same access to quality of care? According to the Sisters Network, a national African American breast cancer survivorship organization, “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.”
However, this doesn’t account for the higher risk of triple negative tumors and likelihood of BRCA gene mutations. This is also acknowledged by the Sisters Network: “There is also evidence that aggressive tumor characteristics are more common in breast cancers diagnosed in black women than other racial/ethnic groups.”
New screening guidelines from the American College of Radiology and the Society of Breast Imaging now call for a risk assessment starting at age 30 for African-American women. Earlier screening, it is believed, may offer African-American women and their doctors the ability to detect cancer at an earlier, more treatable stage.
Not every doctor may be aware of the new ACS guidelines, so if this information affects you, you may want to be prepared with some data to share with your doctor. It will make sense to discuss genetic testing, earlier mammographic screening, and possibly even supplemental screening with automated breast ultrasound or breast MRI if it is determined that you are at high risk.
For more information, visit American College of Radiology (www.acr.org) and the Society of Breast Imaging (www.SBI-online.org). I also encourage you to visit the American Cancer Society website (www.cancer.org) to read the report entitled “Cancer Facts & Figures for African Americans – 2016 – 2018.”