It’s a trend that has long puzzled scientists and public health officials.

Fewer black women get breast cancer than do white women, but a black woman is 40 percent more likely to die of the disease.

Most likely, there are several factors at play, as some aspects of cancer risks are explained by genetics, others by environment, and still more by societal treatment of patients.

Earlier this year, a group of researchers at Weill Cornell Medicine discovered a group of gene variants that they traced back to a region of West Africa and which may increase breast cancer risks for women with ancestors from the area.

According to another study, African American women are at about a 40 percent higher risk of having recurrences after their first breast cancer diagnosis, and their risks of dying from the disease are over 50 percent higher.

A big, but not the only, reason for this is that white women tend to more frequently get two subtypes of breast cancers, called ER-positive or HER2-positive, for which we now have very effective targeted treatments.

Black women, however, are two to three times more likely than white women to get an aggressive type of breast cancer called triple negative breast cancer, which comes back after treatment, and for which there are still no approved targeted treatments. Researchers do not yet know all the reasons why this is so, but are looking for answers.

Black women are also less likely to have genetic screening done than white women are in the first place, though they are more likely to test positive for BRCA1 and BRCA2 gene mutations that put them at risk for certain forms of breast cancer, than their white counterparts.

Studies have shown that a lack of resources makes a huge difference in survival rates, treatment responses, and progression of disease. In the U.S., about 23.1 percent of black women live in poverty, compared to 9.6 percent of white women. Poor women are less likely to have good quality health insurance, get information on early detection and screening, and to have access to the best and latest treatments.

Overall,  there is a great need to improve access to genetic services to the most high-risk women, black women.

Genetic screening is important because patients who become aware of BRCA mutations can take additional steps for cancer prevention. Women who are identified with a mutation have an opportunity to be proactive about their health through cancer preventive options to reduce the risk factors that raise their chances of getting breast cancer.

Public health agencies are working to make sure all women are screened for breast cancer as recommended, including genetic screening,  and the best treatments for those who are diagnosed.

Together, these efforts along with Hereditary Cancer Screening could reduce racial disparities in breast cancer.

Sources: https://www.cdc.gov/cancer/dcpc/research/articles/breast_cancer_rates_women.htm, https://www.dailymail.co.uk/health/article-7078801/Woman-shares-battle-rare-cancer-inspired-make-healthy-care-packages.html, http://theconversation.com/why-is-breast-cancer-mortality-higher-for-african-american-women-than-for-white-women-91381, https://www.mdlinx.com/oncology/article/124

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