Breast cancer outcomes are improving for everyone. But they’re improving much slower for Black women.
“That's the most alarming thing,” said University of California, San Diego breast oncologist Angelique Richardson. “We have all these great things. We're seeing improvements, we're just not seeing it in all groups.”
Black women are 40% more likely to die from breast cancer than white women. Richardson believes that can be changed.
She said the medical community used to think that discrepancy was largely due to genetics. That does play a role. But more recent research shows it’s more about the environment — where people live, work and play — and about unequal health care access.
Black women tend to live farther from large cancer centers, she said. She has some patients who drive four hours just to come for treatment at her clinic.
They typically lack health insurance that would cover transportation or child care.
Treatment hours are usually in the morning. Many Black women, more often the primary breadwinners of their household, can’t afford to take off work.
So they delay treatment, or get it less frequently. Every nine weeks instead of three, for example.
But when access is equalized — like in a breast cancer clinical trial Richardson oversees — that mortality difference goes away, she said.
She urged providers to listen to Black patients.
“I've had a lot of young women in their 20s or 30s — or several, too many — come and say, ‘I felt this and someone told me it wasn't anything and to just kind of wait on it.’ And they've come back and it's been very aggressive cancer later,” Richardson said. “And that has happened fairly often in my Black women. They've just not been really listened to.”
She said she knows from personal experience — even as a medical professional — how hard it can be to advocate for yourself as a Black woman.
Richardson said she’s now looking to partner better with indigenous communities. She said she recently learned that indigenous women have the highest mortality rate from breast cancer in San Diego County.
Her trial is still enrolling new patients.
