Breast Cancer in Young African American Women

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Breast Cancer in Young African American Women

What’s the Problem?

Every year, 24,000 women under the age of 45 are diagnosed with breast cancer; and 3,000 will die as a result. Young African American women under the age of 35 have breast cancer rates that are two times higher than Caucasian women of the same age. Furthermore, young African American women are three times as likely to die from breast cancer as Caucasian women of the same age. Once diagnosed, young African American women face unique challenges that are either not present or are less severe for older women. Having a breast health course of action and discussing the significant implications of a breast cancer diagnosis is essential for young African American women in taking care of their health.

Risks for Younger Women

Younger women tend to face more aggressive breast cancers, are diagnosed at later stages and as a result have lower survival rates. Women aged 45 and younger are more likely to have higher-grade tumors, larger tumor sizes and a higher co-morbidity of lymph node involvement than women over 65. The relative five-year breast cancer survival rate is lower in women diagnosed with breast cancer before the age of 40 (82%) compared to women diagnosed with breast cancer at the age of 40 or older (89%). Being aware of risk factors and consulting a doctor about breast health is important for young African American women to mitigate and manage their risk.

The lack of awareness among young African American women on their risk for breast cancer is often a factor into why they have more harsh outcomes. Approximately 40% of young women with breast cancer had no idea a young woman could get breast cancer prior to their own diagnosis. Fear and stigma are commonly cited reasons for not getting a mammogram. Unfortunately, cultural barriers like fear and stigma associated with illness and poverty deter African American women from getting breast cancer screenings, which results in a late stage diagnosis. Lack of dialogue among families about generational health and increased risks are key barriers to women taking the steps to minimize their risk of breast cancer.

Young women under the age 45 have a higher risk for breast cancer if

• A close relative (parent, sibling or child) was diagnosed with breast or ovarian cancer at an age younger than 45.
• They have other breast health problems or were treated with radiation therapy to the breast or chest during childhood or early adulthood.
• They have changes in certain breast cancer genes (BRCA1 and BRCA2), or have close relatives with these changes.

Prevention

REDUCING RISK. Unfortunately, there is no effective method of screening for young women. Young African American women should be familiar with how their breasts normally look and feel and be aware of the signs of abnormal breast health in order to take the proper steps to manage their risk. Knowing the signs of breast malignancy can save lives.  80% of young women ultimately diagnosed with breast cancer find their breast abnormality themselves and the earlier the abnormality is found, the greater the survival rate. More importantly, African American women need to feel comfortable and even encouraged to talk about their bodies. Recognizing the signs of abnormal breast health and consulting a doctor to assess concerns if any known symptoms appear is important to reduce the risk of breast cancer in young African American women. Symptoms include: change in shape or size of the breast, pain in the breast, and a liquid discharge other than breast milk. Women who are at higher risk for breast cancer at a young age should consult their doctor to learn more about how to manage their risk.

AFTER DIAGNOSIS. Young women face unique challenges upon being diagnosed with breast cancer, including:

1) The possibility of early menopause caused by chemotherapy,

2) Effects on fertility,

3) Psychological distress including concerns about body image and

4) Disruption of employment (both voluntary and involuntary) and challenges to financial stability.  A breast cancer diagnosis in young women interferes at a transition point in their lives.  Treatment for breast cancer has the potential to impact the life of a young woman in ways that are less pertinent or less severe to older women.  Once diagnosed, it is important that young women consult with their health care team to understand the impact breast cancer treatment can have on their lives.

The Bottom Line

• Of all new cases of breast cancer in the United States, 11% are found in women less than 45 years of age ·
• Young African American women are disproportionately affected by breast cancer compared to young Caucasian women.
• Death rates due to breast cancer are three times higher in young African American women than in young Caucasian women ·
• Being aware of abnormal breast health and consulting a doctor to discuss risk management is an important way to reduce breast cancer risk in young African American women ·
• Once diagnosed, young African American women face unique challenges that should be discussed with a health care team.

Case Example

As a teenager, Nina watched her grandmother battle breast cancer. Her Mom and Aunt took charge of her Grandma’s health, but never discussed how the disease could affect other women in the family. Nina, at 28 years old, is hesitant to speak to her doctor about the lump she felt in her breast while taking a shower. Her family is still pained by the loss of her grandmother, so bringing up the issue to them would just open up old wounds. Flipping through a magazine in the doctor’s waiting room, she sees the image of a young woman, not too different from her, and an article discussing her battle with breast cancer. She is shocked to learn that a young woman can be affected by breast cancer. But this knowledge encourages Nina to take action to learn more about what could be a potentially life-threating situation. Nina not only learns about breast cancer statistics and the steps she needs to take, but feels empowered by this young woman’s story. As she walks into her appointment, she is ready to discuss her own breast health with her doctor.

Spanish Version of Breast Cancer in Young African American Women [PDF – 223K]