• An estimated 19,010 new cases of breast cancer are expected to occur among African American women in 2007.
• Breast cancer is the most common cancer among African American women.
• The incidence rate of breast cancer is
about 12% lower in African American women than in white women; however, among younger African American
women (under age 40), the incidence is higher than among white women.
• Breast cancer incidence rates increased rapidly among African American women during the 1980s, largely due to the increased use of mammography.
• Since the early 1990s, breast cancer incidence rates have stabilized among African American women aged 50 and
older, and are decreasing among women under age 50.
An estimated 5,830 deaths from breast cancer are expected to occur among African American women in 2007. Breast cancer is the second most common cause of cancer death among African American women, surpassed only by lung cancer.
Breast cancer death rates among African American women increased 1.6% annually from 1975 - 1991 and declined thereafter. However, the decrease was larger in women under age 50 (1.9% per year) than in women aged 50 and older (1.1%). The steady decline in female breast cancer mortality since 1991 has been attributed to improvements in both early detection and treatment. However, there has been a notable divergence between long-term breast cancer mortality rates for white and African American women.
During the early 1980s, breast cancer death rates for white and African American women were approximately equal, yet during 2000-2003 African American women had a 36% higher death rate than white women. This difference accounts for one-third of the excess cancer mortality experienced by African American women compared to white women. The higher breast
cancer mortality rate among African American women compared to white women occurs despite a lower incidence rate. Factors that contribute to the higher death rates among African American women include differences in access to and utilization of early detection and treatment, risk factors that are differentially distributed by race or socioeconomic status, or biologic differences associated with race.
The 5-year relative survival rate for breast cancer diagnosed in 1996-2002 among African American women
was 77%, compared with 90% among whites. This difference can be attributed to both later stage at detection
and poorer stage specifi c survival. Of all breast cancers diagnosed among African American women, 52% are
diagnosed at a local stage, compared to 62% among white women. Within each stage, the 5-year survival is also
greater among white women.
The reasons for this survival differential have been studied extensively. Poorer outcomes among African American
women persist even after accounting for socioeconomic status. Studies have documented unequal receipt of
prompt, high-quality treatment for African American women compared to white women. There is also evidence
that aggressive tumor characteristics are more common in African American women than white women. More
information about breast cancer is available and the American Cancer Society publication Breast Cancer Facts & Figures (8610.05)or from the American Cancer Society web site at www.cancer.org.
What are the risk factors?
Long menstrual history
Never having children
Personal history of breast or ovarian cancer
*Over 74% of breast cancers are diagnosed in women with no identifiable risk factors.What are the warning signs?
Lump, hard knot or thickening in the breast
Swelling, redness or increased warmth in the breast
Change in the size or shape of the breast
Itchy, sore or scaling area on the nipple/areola
Nipple discharge (particularly if bloody) that starts suddenly
Pulling in of the nipple (inverted nipple) or nipple change direction (retracted nipple)
Dimpling or puckering of the skin on the breast
Unusual pain in an area of the breast
Monthly breast self-exam (BSE) starting at age 20*
Clinical breast examination by a trained medical professional every 2-3 years beginning at age 20, and annually after age 40
Mammography screening every one to two years for women ages 35-40 (If your mother or sister has had breast cancer, you may need to get mammogram earlier and more frequently)
Annual mammography screening for women age 40+**
*BSE should be done just as your period ends or for post-menopausal women, the same day each month. Most women discover breast masses during monthly breast self-examination. This simple and easy to follow examination allows a woman to become more familiar with her breast, making the detection of subtle changes or abnormities easier.
**Women receiving annual mammography screening are 30% less likely to die from breast cancer compared to unscreened women.
***Breast ultrasound is frequently useful in evaluating breast and mammographic abnormalities, especially in young women.
What are the factors that place a woman at increased risk for breast cancer?
Every woman has some risk for developing breast cancer during her lifetime, and that risk increases as she ages. However, the risk of developing breast cancer is not the same for all women. The following are the some factors known to increase a woman's chance of developing this disease:
Personal History: Women who have had breast cancer are more likely to develop a second breast cancer.
Family History: The risk of getting breast cancer increases for a woman whose mother, sister, or daughter has had the disease; or who has two or more close relatives, such as cousins or aunts, with a history of breast cancer (especially if diagnosed before age 40). About 5 percent of women with breast cancer have a hereditary form of this disease.
Genetic Alterations: Specific alterations in certain genes, such as those in the breast cancer genes BRCA1 or BRCA2, make women more susceptible to breast cancer.
Abnormal Biopsy: Women with certain abnormal breast conditions, such as atypical hyperplasia or LCIS (lobular carcinoma in situ), are at increased risk.
Other conditions associated with an increased risk of breast cancer: Having children at a later age or never having children at all, early onset of menses, taking hormones over an extended period of time, and exposure to environmental hazards.
What is the best method of detecting breast cancer as early as possible?
A high-quality mammogram, with a clinical breast exam, is the most effective way to detect breast cancer early. Using a mammogram, it is possible to detect breast cancer that cannot be felt. However, like any test, mammograms have both benefits and limitations.
How much does a mammogram cost?
Most screening mammograms cost between $50 and $150. Most states now have laws requiring health insurance companies to reimburse all or part of the cost of screening mammograms. Details can be provided by insurance companies and health care providers. Medicare pays 80% of the cost of a screening mammogram each year for beneficiaries age 40 or older. There is no deductible requirement for this benefit, but Medicare beneficiaries are responsible for a 20% co-payment of the Medicare-approved amount. Information on coverage is available through the Medicare Hotline at 1-800-MEDICARE. Some state and local health programs and employers provide mammograms free or at low cost. Information on low-cost or free mammography screening programs is available through the NCI's Cancer Information at 1-800-4-CANCER.