Breast cancer is the most common type of cancer among women and impacts all ages, races, and ethnic backgrounds. However, data shows that while white women in the U.S. are most likely to be diagnosed with breast cancer, it's black women who are most likely to die of this disease. Why is that? Do the outcomes vary for other races? And what can you do to protect yourself and those you love?
Risk Factors Related to Breast Cancer
There are several complex reasons why breast cancer diagnosis and death rates vary across races, including genetics, lifestyle choices, and access to healthcare. While there is an established set of breast cancer risk factors, several are more common in some races than in others, such as:
- Body weight
- Breast density
- Access to healthy foods
- The age at which menstruation began
- Age at first childbirth and the total number of childbirths
- Duration of breastfeeding
- Age at menopause
- Use of menopausal hormone therapy
For instance, black women are 50 percent more likely to be obese compared to white women and less likely to breastfeed. White women are more likely than women of other ethnicities, including black and Hispanic women, to have children at a later age, have fewer children, and utilize menopausal hormone therapy. In both of these cases, the risk of developing breast cancer increases.
Let’s look at differences in breast cancer risks and incidence rates across races.
Breast Cancer Differences Among US Racial Groups
Asian American and Native Hawaiian/Pacific Islander Women
The incidence of breast cancer is on the rise among Asian-American subgroups, particularly among women of Korean and Southeast Asian descent. Unfortunately, the rate of breast cancer cases among Asian American women has increased by 10% over the past decade, according to the Centers for Disease Control and Prevention.
The reason for this increase isn’t clear, but it is being studied. One researcher, Dr. Veronica Setiwan from Keck School of Medicine of the University of Southern California, said the trend may be related to Asian immigrants adopting some lifestyles that put them at higher risk. “Asian women, American women, they become more westernized so they have their puberty younger now — having earlier age at [the first menstrual cycle] is associated with increased risk…maybe giving birth later, we delay childbearing, we [Asian American women] don't breastfeed — those are all associated with breast cancer risks."
Another challenge is that established breast cancer risk factors —such as body mass index (BMI) and breast density—do not work in the same way for Asian women as they do compared to other populations, according to Yiming Gao, MD, associate professor, Department of Radiology at NYU Grossman School of Medicine. This makes it harder to use these risk factors as an indicator of when to start screening for Asian-American and Pacific Islander women.
There was also a long-held cultural hesitation for Asian women related to breast cancer screening. This may have been holding back some from getting their mammograms. As this hesitancy fades, more women are getting screened, which means more women are likely diagnosed.
Black Women
Black women are more likely to die of breast cancer in the United States than white women, even though more white women are diagnosed every year. Overall, black women are typically diagnosed at younger ages, they are more likely to be diagnosed with an aggressive form of breast cancer, and their cancers are often detected at more advanced stages.
There are several possible reasons for these differences:
- Access to quality healthcare: Black women have the highest screening rates; however, studies indicate that they are less likely to receive high-quality screenings and timely follow-up after abnormal results.
- Genetics: A study by the Journal of the American Medical Association recommends black women should start screening as much as eight years earlier than other races since breast cancer tends to be found in younger black women compared to the rest of the population. This could be related to genetic differences between races. Talk to your doctor about starting screening before age 40 if you’re a black American woman.
A Breast Cancer Research Foundation study also shows that Black women are more likely to have the genetic mutations that lead to more aggressive subtypes of breast cancer, such as inflammatory breast cancer and triple-negative breast cancer. These types of breast cancer tend to be diagnosed at an earlier age. - Slower to follow up on abnormal mammograms: Black women tend to delay follow-up breast care for a longer period after an abnormal mammogram than white women, which can play a role in their lower survival rates. By not acting quickly after a diagnosis, the cancer has time to grow and spread to other areas of the body.
Related Read: What is Triple-Negative Breast Cancer?
Hispanic and Latina Women
Hispanic women and Latinas share a similar culture, but they are two distinct groups with unique breast cancer risks. Overall, these women are 25% less likely to develop breast cancer compared to white women in the United States. Still, breast cancer remains the leading cause of cancer-related death in their population.
These groups are often diagnosed at a younger age with more aggressive forms of breast cancer, such as triple-negative breast cancer. Although this type of cancer is treatable, Hispanic and Latina women frequently receive diagnoses at more advanced stages, often due to delayed or infrequent mammograms as well as limited access to health care, ultimately impacting their overall prognosis.
Lifestyle choices, particularly dietary habits, may also contribute to the disparities observed between these two groups of women. Adopting an American diet—whether by personal choice or due to limited access to fresh foods—rather than consuming a more nutritious diet typical of many ethnic groups in Latin America is linked to weight gain, a known risk factor for breast cancer.
Non-Hispanic White Women
White women have the highest breast cancer diagnosis rate in the US but the second highest mortality rate after black women. This difference is likely attributed to socioeconomic factors, which allow white women greater access to breast cancer screening and treatment compared to women of other races in the United States. More mammograms in this group will typically lead to more diagnoses.
The reasons for the slight increase in breast cancer rates among white women compared to their black counterparts are not entirely clear. However, it is suspected that factors such as having children at a later age, having fewer children overall, and using hormonal therapy during menopause may contribute to this increased risk. Each of these factors is associated with a higher likelihood of developing breast cancer.
Breast Cancer Screening Among Various Races
Breast cancer screening is the most effective way to detect breast cancer early when it is most treatable. However, how often mammograms occur within individual groups varies based on factors such as finances, geographic location, and access to healthcare.
Learn more about breast cancer screening.
According to the American Cancer Society (ACS), in 2021, approximately 49% of women aged 40 and older had a mammogram within the past year, and 67% had one in 2022 and 2023. The lowest screening rates are observed among American Indian and Alaska Native women. This is likely due to cultural resistance to having a mammogram, which can help find cancer when it’s small and easier to treat.
The ACS also states in their 2024-2025 Breast Cancer Facts and Figures report that compared to white women, black women have a lower risk of developing breast cancer. Still, they are 38% more likely to die from the disease. Additionally, American Indian and Alaska Native (AIAN) women have a 10% lower incidence of breast cancer than white women, but their mortality rate is 6% higher.
The best thing to do is get your regular screenings and follow up as soon as possible if something abnormal is found in the mammogram. If you are at a higher risk level, talk to a doctor about starting screening before age 40.
Breast Cancer Screening and Cancer Treatment in Colorado
It can be scary, but if cancer is found early, you’re likely to have a much better outcome than if you wait. Mammograms are covered by insurance, including Medicaid. If you don’t have insurance, learn more about free screening for women through the state of Colorado with Women’s Wellness Connection.
If you or your loved one recently received a breast cancer diagnosis, the next step is to meet with an oncologist. Rocky Mountain Cancer Centers has breast cancer specialists throughout Colorado, including Boulder, Colorado Springs, and Denver. We encourage you to request an initial consultation or a second opinion to ensure complete confidence in the recommended treatment plan.
