Black women are more likely to die of breast cancer than white women even when they have tumors that should be treatable and have good survival odds, a new study suggests.
Especially with the most treatable forms of breast cancer, the higher mortality rates for Black women point to a gap between what doctors know can be done for patients and the care some patients actually receive, says the senior study author, Erica Warner, ScD, MPH, an assistant investigator at Massachusetts General Hospital and an assistant professor at Harvard Medical School in Boston.
“We know that because of the legacy and ongoing effects of structural racism, Black women in the U.S. have on average lower socioeconomic status, are more likely to be uninsured or underinsured, and receive care from lower-resourced institutions,” Dr. Warner says.
“There’s also the issue that when there’s more we can do to intervene, to reduce risk, to find cancer early, to treat it with curative intent, there’s more opportunity that some people receive those benefits and others don’t, and that’s where disparities are created,” Warner adds.
Racial Disparities Exist for All Types of Breast Tumors
The study identified a bigger racial disparity for hormone-positive tumors, with the mortality rates 34 to 50 percent higher among Black women than white women. Mortality rates were also 17 to 20 percent higher for Black women with harder-to-treat hormone-negative tumors, including so-called triple negative tumors, the study found.
“We’d hypothesized that we’d see the biggest disparities in the most treatable forms of the disease, namely the hormone receptor positive tumors,” Warner says. “But we saw persistent disparities in the triple negative tumors, too.”
This underscores the importance of timely treatment even for triple negative tumors that have limited targeted therapy options, Warner says. “Finding these tumors early and treating them quickly is lifesaving,” Warner says.
Black Women Aren’t Getting the Cancer Care They Need
The study wasn’t a controlled experiment designed to prove whether or how any specific factors might directly worsen survival odds for Black women.
Even so, the results offer fresh evidence that Black women aren’t getting the care they need to achieve the same survival rates as white women with the same types of breast cancer, says Katherine Reeder-Hayes, MD, a professor and the chief of breast oncology at the UNC Lineberger Comprehensive Cancer Center in Chapel Hill, North Carolina.
“For most Black women with breast cancer, the vast majority of the breakdowns that lead to disparities don’t occur because the patient was unwilling to do something to cure their cancer,” says Dr. Reeder-Hayes, who wasn’t involved in the new study. “They occur because our health system and the other social systems around it, like our health insurance and medical education systems, failed to provide the opportunity that the patient needed to find their cancer early and get it treated most effectively.”
