Breast Cancer Survival Rates Are Up – But Racial Inequality Is Still a Major Problem

woman holding tablet in front of her chest

While death rates have dropped overall, Black women are more likely to die from the disease.

The death rate from breast cancer in U.S. women has dropped significantly in the last few decades, but even though they’re less likely to experience the disease, Black women are dying from it much more frequently.

According to a new report from the American Cancer Society, published on October 3 in the CA: A Cancer Journal for Clinicians, the female breast cancer death rate dropped by 43 percent between 1989 and 2020, meaning that 460,000 fewer women have died from the disease in that time.

However, despite a 4 percent lower incidence of breast cancer in Black women compared with White women, the death rate remains 40 percent higher in Black women overall, with 27.6 vs. 19.7 deaths per 100,000 in the years 2016–2020. It’s twice as high among Black women who are less than 50 years old.

Failed by the system

“The evidence is consistent that Black women receive short shrift in the health care system at every point of the breast cancer care continuum, from lower-quality mammography to delays between the time of diagnosis and the beginning of treatment to poor quality treatment when they are diagnosed,” said Rebecca Siegel, senior scientific director of surveillance research at the American Cancer Society and senior author of the report, according to CNN. “The take-home message is that we really need to take a hard look at how we’re treating Black women differently.”

The report adds that Black women have the lowest 5-year relative survival of any racial or ethnic group for every molecular subtype and stage of disease besides stage I. It also notes that while mortality rates declined at a similar rate across most ethnic groups, they remained stable among American Indians/Alaska Natives (AIANs).

Most new breast cancers are discovered during screenings at a stage when they’re still localized — that is, they haven’t spread beyond the breast — and are therefore easier to treat.

A slight rise in overall breast cancer frequency

A slight rise in the overall frequency of breast cancer in American women between 2010 and 2019 — by about 0.5 percent per year — has been attributed to an increase in excess body weight, and a decline in overall fertility. As the American Cancer Society notes, experiencing pregnancy before the age of 30, and having multiple pregnancies, can contribute to a decreased risk of developing breast cancer.

“An estimated 30 percent of breast cancer cases are attributed to modifiable risk factors, such as excess body weight, physical inactivity, and alcohol intake, and thus may be preventable,” reads the report.