Triple-negative breast cancer in Black women: Risks and outlook

A 2021 study involving more than 198,000 women found that Black women are 2.7 times more likely to receive a diagnosis of TNBC than white women.

However, research suggests that the prevalence of TNBC among Black women varies based on where they were born.

In a 2019 study, researchers used data on more than 65,000 non-Hispanic Black women who received a diagnosis of breast cancer between 2010 and 2015. They found that the participants born in the United States or Western Africa had higher rates of TNBC diagnoses than those born in the Caribbean or East Africa.

Compared with women born in the U.S., the prevalence of breast cancer was 13% and 47% lower among women born in the Caribbean and East Africa, respectively.

The researchers say that there are many possible causes of this variation in prevalence among Black women.

Possible factors include:

• genetics
• health behaviors
• social structures
• income

Researchers believe that a combination of factors contributes to the increased risk of TNBC among Black women.

Tumor biology

In a 2020 analysis, researchers noted that there were genetic differences between Black women and white women with TNBC. They found that Black women had higher rates of certain gene mutations than their white peers.

Tor example, 46% of the Black women in the study had a TP53 mutation, compared with 27% of the white women.

TP53 is the most commonly mutated gene in breast cancer. When functioning normally, the TP53 gene acts as a tumor suppressor and stops cells from growing out of control. When it mutates, the TP53 gene can cause cells to replicate rapidly.

Obesity

Obesity raises the risk of several cancers. In the U.S., obesity disproportionately affects Black women.

Recent data suggest that 57.2% of Black women in the U.S. have obesity compared with 38.2% of non-Hispanic white women. The data also show that 16.8% of Black women have a body mass index (BMI) over 40 compared with 9.7% of non-Hispanic white women.

In a 2016 study, researchers found that women with a BMI of 30 or higher had an 82% greater risk of TNBC. Those in the highest quartile of body weight had a 79% increased risk of TNBC compared with those in the lowest quartile.

However, it is important to note that non-Hispanic white women accounted for the majority of the cohort.

A number of social factors likely contribute to the development of obesity and can, in turn, lead to the development of TNBC. These include:

• income disparity
• lack of access to a variety of nutritious foods, such as fresh vegetables
• lack of exercise
• high intake of inexpensive foods that are high in calories

Social factors

Numerous social factors may play a role in the high rates of TNBC in Black women. These include:

• poverty
• unsafe neighborhoods
• lack of access to healthcare
• social stress

A growing body of research suggests that women with a lower socioeconomic status are more likely to receive a diagnosis of breast cancer in the later stages. Compared with white women, Black women are more likely to live in lower socioeconomic neighborhoods and to have either public or no health insurance.

Problems with social inequality and unsafe neighborhoods may lead to higher rates of obesity among Black women, which is a risk factor for a number of cancers, including TNBC.

Research suggests that Black women have higher mortality rates from breast cancer than white women.

In a 2021 study, researchers found that Black women with TNBC were 28% more likely to die than white women who received the same diagnosis.

Black women are more likely to receive a diagnosis at a later stage of disease than their white counterparts. They also have the lowest rates of survival for any stage of diagnosis.

Numerous studies have indicated that both treatment and outcomes for Black women differ significantly from the experience of white women across all forms of breast cancer.

Black women are less likely to receive the appropriate treatment that aligns with national guidelines. The same 2021 study found that Black women have a 31% lower chance of having surgery than white women and are 11% less likely to have chemotherapy.

Several factors may contribute to the disparity in care and treatment of Black women with breast cancer. These include:

• systemic racism
• communication issues with healthcare professionals
• less likely to receive the appropriate standard of care
• difficulties with travel to access care
• financial struggles
• difficulties taking time off work

All people deserve to receive a high standard of care to give them the best possible outlook. The standard of care for TNBC includes surgery, chemotherapy, and, in some cases, radiation therapy.

Although Black women may have an increased risk of TNBC, getting started on the right treatment can lead to the best possible outcomes. Anyone who is not satisfied with the response that they get from a healthcare professional should consider seeking a second opinion, if possible.