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Breast Cancer Rates Are Rising Among African American Women

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Key Points

  • Between 2006 and 2010, breast cancer rates increased 0.2% among African American women but remained stable among white women.
  • Although white women experience more cases of breast cancer, death from breast cancer is more common among blacks than among whites. African American women have the poorest breast cancer survival of any racial/ethnic group.
  • African American women have the highest rates of ER-negative breast cancer, potentially due to factors such as obesity, income level, reproductive history, and genetic differences.

Although, historically, white women aged 40 years and older have had the highest incidence rates of breast cancer, the rising rate of breast cancer among African American women—especially among women aged 50 to 59—is narrowing the gap, according to a study by American Cancer Society (ACS). The study found that between 2006 and 2010, breast cancer rates increased 0.2% among African American women but remained stable among white women. And while white women still experience more cases of breast cancer with about 127 cases per 100,000, compared with 118 cases per 100,000 African American women, death from breast cancer is more common among black women—30.8 per 100,000 vs 22.7 per 100,000 among whites. The study is published in CA: A Cancer Journal for Clinicians.

According to the report, since 1990, breast cancer death rates have decreased by 34% among all racial/ethnic groups except American Indians and Alaska Natives. However, survival disparities persist by race and ethnicity, with African American women having the poorest breast cancer survival of any racial/ethnic group.

“The higher death rate among African Americans, despite their having a lower incidence rate than non-Hispanic whites, is due to both a later stage of disease at diagnosis and poorer stage-specific survival….Poverty, less education, and a lack of health insurance are also associated with lower breast cancer survival,” wrote the study authors.

Trends by Estrogen Receptor Status

The ACS used data for incidence, probabilities for developing cancer, and cause-specific survival from the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute (NCI). For this report, the ACS also examined breast cancer incidence trends by estrogen receptor (ER) status and age at diagnosis.

The researchers found that between 2006 and 2010, in every age group, white women had the highest rates of ER-positive breast cancer and African American women had the highest rates of ER-negative breast cancer. The reason may be due to factors such as obesity, income level, and reproductive history.

“Reproductive history and obesity appear to be more strongly associated with ER-positive breast cancer, whereas lower socioeconomic status is associated with an increased risk of ER-negative breast cancer,” wrote the study authors. Genetic differences may also play a role, according to the report.

Reducing Breast Cancer Risk

Clinical strategies that may help reduce the risk for breast cancer include avoiding weight gain and obesity, engaging in regular physical activity, minimizing alcohol intake, and evaluating the use of combination estrogen and progestin hormone therapy for patients with menopausal symptoms. The report recommended that clinicians discuss the use of tamoxifen and raloxifene (Evista) for chemoprevention with women at an increased risk of breast cancer. It also recommended that clinicians follow ACS screening guidelines.

“Continued progress in the control of breast cancer will require sustained and increased efforts to provide high-quality screening, diagnosis, and treatment to all segments of the population,” concluded the report.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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