Breast cancer now leads cancer deaths in Black women; screening, and conversations can help

Every Black woman, regardless of her current state of health, needs a health support system and a team of advocates. That’s advice from Dr. Avanti Mehrotra, an oncologist and hematologist at North Memorial Health (NMH). The reason? Breast cancer is now the leading cause of cancer death in Black women.

According to a recent study published by the American Cancer Society (ACS), breast cancer has surpassed lung cancer as the top cause of cancer death among Black women. (This is due to a sharp decline in lung cancer, which is a result of less smoking, earlier diagnosis, and better treatment.)

And while the breast cancer mortality rate is also falling (by about 1% every year), it’s still a big problem, especially in the Black community. Black women are 41% more likely to die from breast cancer than their white counterparts, according to the ACS. 

This is why some of the strongest health advice Dr. Mehrotra has for women in the Black community is to get a mammogram and to “tell other women in your life to get one too.” 

According to the ACS, the reasons for racial disparities in cancer rates are complex, but are “largely driven by decades of structural racism leading to a higher risk of lower socioeconomic status.” 

Those structural forces have had many powerful effects, including, as Dr. Mehrotra noted, reduced access to healthcare and health insurance, as well as a general mistrust in the healthcare system. Historical harms such as the Tuskegee Study and the use of Henrietta Lacks’ cells have contributed to the hesitancy among many people in the Black community to rely on healthcare.

This very history is among the reasons Black women should be having more conversations with one another and with their doctors about their health, said Dr. Mehrotra. “We need to be sure [Black women] have access to mammograms and then go ahead and get them,” she said.

The conversations can potentially help reduce the negative impacts that system-level inequities in healthcare have on Black women personally, and in turn, hopefully, help lead to improvements in the systems and processes. 

“What we really want to do is we want to break the cycle of harm that has been historically done,” Dr. Mehrotra said. “We want to acknowledge that, and we want to reduce the barriers to care going forward.  We want to have systems in place so as to encourage our patients to come in and feel comfortable getting the healthcare they need and deserve.”

While Dr. Mehrotra cautions that having these conversations is not a solution to the underlying issues and barriers, she stressed that communication can be a helpful tool.

“By sharing their stories about their health and their mammograms with other women,” she said, Black women can help each other feel more comfortable seeking necessary care. 

Early detection of breast cancer can help get treatment started before the disease progresses to a more severe stage. Starting at the age of 40, women should be screened for breast cancer every 1-2 years, Dr. Mehrotra said. Pay attention to changes in your breast, like a lump, redness, an inverted nipple, skin dimpling, skin thickening and pain. And schedule an appointment with a doctor right away if you find cause for concern.

North Memorial Health is working to make access to getting a mammogram easier, more accessible and more equitable for Black women, said Jessi Kingston, who is the System Director for Diversity, Equity and Inclusion for North Memorial Health.

“We understand that communities of color have a mistrust,” Kingston said, “and we are working hard through partnerships and engagement, and by providing tools and access, and by building relationships to help break down these barriers of mistrust.”

Among those tools are digital and 3D mammograms, which can find more cancers than traditional 2D mammograms and also reduce the number of false positives. “A digital mammogram is a very good mammogram,” Dr. Mehrotra said. Access to digital mammography and 3D mammography is now available at the NMH Breast Center in Robbinsdale. 

In general, this technology is often not made as available to people of color as it is to their white counterparts. According to Breastcancer.org, “compared to white women, researchers found that Black, Hispanic, and Asian women were less likely to have a 3D mammogram than a 2D mammogram when both types of mammograms were available at the facility at which they were screened.”

This is among the sort of unequal access to medical care that NMH is working toward ending. “We want to make sure that Black women are getting equitable healthcare and treatment options,” Kingston said.

Kingston, who is half-Black, noted how important it is to get screened. She happened to schedule a mammogram—just because she had time do so—when she was 40. She was able to get a 3D mammogram and it caught her breast cancer, which led to her getting treatment she otherwise wouldn’t have known she needed.

“It can hit at any time,” Kingston said. “I had no symptoms that would indicate that I had breast cancer.”

“I know how critical it is to get screened,” she said.

Detecting breast cancer early can help immensely improve health outcomes and your chances of survival. And even before you go for your first mammogram, there are basic health steps you can take to help reduce your risk of getting breast cancer. Dr. Mehrotra notes:

• If you drink alcohol, drink as little as possible—no more than 4 drinks a week
• Don’t smoke
• Eat a balanced diet that is low in fat and rich in fiber 
• Engage in moderate, consistent exercise for 30 minutes a day, 5 days a week
• Avoid obesity
• Treat and control diabetes
• Treat and control hypertension

Being well informed and proactive about your health are some of the best things you can do, Dr. Mehrotra said. “Talk to your family, your friends, mothers, sisters. Make sure to talk about women’s health issues,” she said, “And establish a rapport with your healthcare professional.”

“I tell women, even if you have no family history, when you turn 40, go get yourself the birthday gift of a mammogram,” Dr. Mehrotra said. “The earlier we find it, the more we can do about it.” 

North Memorial Health offers mammography services at their breast centers in Robbinsdale and Maple Grove, and at four clinics throughout the metro area, each with walk-in availability—no appointment is necessary. To learn more or to schedule a mammogram, visit northmemorial.com today.

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