Breast cancer is a significant health concern that affects people worldwide, transcending racial, ethnic, and gender boundaries. Despite advances in treatment, breast cancer remains a leading cause of cancer-related deaths globally.
Breast cancer occurs when cells in the breast grow uncontrollably, forming a tumor that can invade surrounding tissues or spread (metastasize) to other parts of the body. Though breast cancer is most commonly associated with women, men can also develop the disease, though at a much lower rate.
Breast cancer often begins in the milk-producing ducts (ductal carcinoma) or in the lobules, which supply milk (lobular carcinoma). Understanding the different stages of breast cancer is key to determining treatment and outcomes.
The progression of breast cancer is categorized into stages based on the size of the tumor and whether it has spread to nearby lymph nodes or other parts of the body.
Stage 0 (Carcinoma in situ): Abnormal cells are found in the lining of a breast duct or lobule, but they haven’t spread to surrounding tissues. This stage is not considered invasive but is a warning sign that cancer may develop.
Stage I: At this stage, cancer is considered invasive, but the tumor is small (up to 2 cm) and hasn’t spread beyond the breast.
Stage II: The tumor may be larger than in Stage I or may have spread to nearby lymph nodes, but not to distant parts of the body.
Stage III: This stage involves more extensive cancer that has spread to lymph nodes near the breastbone or under the arm. The tumor may be larger or involve multiple lymph nodes.
Stage IV (Metastatic breast cancer): At this advanced stage, cancer has spread beyond the breast and nearby lymph nodes to other organs, such as the lungs, liver, or bones.
Breast cancer doesn’t affect all demographics equally. Black and Brown women, particularly those of African American, Afro-Caribbean, and Hispanic/Latina descent, face unique challenges in breast cancer detection, treatment, and outcomes. According to the American Cancer Society, Black women are more likely to be diagnosed with breast cancer at younger ages and are at a higher risk of developing aggressive forms, such as Triple Negative Breast Cancer (TNBC), which is harder to treat.
- Mortality rates: Black women are about 40% more likely to die from breast cancer than white women, despite having a lower overall incidence rate. This is due to disparities in access to care, delayed diagnosis, and a higher prevalence of aggressive cancer types.
- Age of diagnosis: Black women tend to be diagnosed with breast cancer at younger ages. A significant portion of Black women is diagnosed under 40, an age group for which routine mammograms are not yet recommended by many health organizations.
- Hispanic/Latina women: While Hispanic women have lower breast cancer incidence rates compared to other ethnicities, they are more likely to be diagnosed with advanced stages of the disease, leading to worse survival outcomes.
Current guidelines recommend mammograms starting at age 40 or 50, depending on the health organization. However, for women of color, who are often diagnosed younger, these guidelines may come too late.
Lowering the mammogram age is particularly important for the following reasons:
Early Detection Saves Lives: Catching cancer at an earlier stage often results in more treatment options and higher survival rates. This is especially vital for Black women, who are more frequently diagnosed with breast cancer under the age of 40.
Aggressive Cancers: Black women have a higher incidence of Triple Negative Breast Cancer (TNBC), a subtype that grows faster and has fewer treatment options. Early detection through screening is crucial to combat the aggressive nature of TNBC.
No Family History Doesn’t Mean No Risk: Many women believe that if breast cancer doesn’t run in their family, they’re not at risk. However, most breast cancer cases occur in women with no family history of the disease. About 85% of breast cancer cases are diagnosed in women without a known genetic predisposition. This highlights the importance of screening for all women, regardless of their familial background.
Treatment varies depending on the stage, type, and genetic factors of the cancer, but it often includes a combination of the following:
Surgery: The primary goal is to remove the tumor. Options include a lumpectomy (removing the tumor but preserving the breast) or a mastectomy (removing one or both breasts).
Radiation Therapy: High-energy rays are used to target and destroy cancer cells. This is often used after surgery to eliminate any remaining cancerous cells.
Chemotherapy: Powerful drugs are administered intravenously or orally to destroy cancer cells. Chemotherapy is often used when cancer has spread or if it’s an aggressive type, such as TNBC.
Hormone Therapy: For cancers that are hormone receptor-positive, treatments like tamoxifen or aromatase inhibitors can block the hormones that fuel the cancer’s growth.
Targeted Therapy: These drugs target specific proteins or genes involved in the cancer’s growth. HER2-positive breast cancer, for example, can be treated with targeted therapies like trastuzumab (Herceptin).
Immunotherapy: An emerging treatment, immunotherapy helps the immune system recognize and attack cancer cells. This is particularly promising for treating Triple Negative Breast Cancer.
Clinical trials play an essential role in developing new and effective treatments. Unfortunately, people of color are underrepresented in clinical trials, which means that the treatments developed may not fully reflect how effective they are for diverse populations.
Participating in clinical trials can offer access to cutting-edge treatments and help ensure that future therapies work for all demographics. It’s important to advocate for more inclusion of Black and Brown patients in these trials, as their participation can directly impact the effectiveness of treatments in their communities.
One of the most pervasive myths about breast cancer is that it only affects those with a family history. While having a family history of breast cancer does increase risk, the vast majority of cases—around 85%—occur in women with no known family history. Environmental factors, lifestyle, and even random genetic mutations can contribute to the development of breast cancer, which is why screening is essential for everyone.
Breast cancer doesn’t discriminate, but access to early detection, treatment, and clinical trials often does. Addressing disparities in breast cancer care is crucial to saving more lives, especially in Black and Brown communities. Lowering the age for mammograms, encouraging participation in clinical trials, and understanding that breast cancer can occur without a family history are all vital steps in the fight against this disease.
Advocacy, awareness, and action are needed to ensure that everyone, regardless of race or ethnicity, has access to the care and resources they need to beat breast cancer. Early detection saves lives—let’s make sure no one gets left behind.
