Why the need for targeted awareness-raising?
- Breast cancer affects everyone, regardless of age, sex, gender identity, sexual orientation and ethnocultural background.
- Detecting breast cancer earlier allows for more effective, less aggressive treatments and better chances of recovery. This is why it is important to be aware of the possible signs of breast cancer, as well as the proper prevention habits to adopt.
- According to recent data, there are disparities in detection times between ethnocultural groups. For Black communities, the lower rate of early detection is said to have a significant impact on:
- stage of cancer at diagnosis;
- quality of life throughout the breast cancer trajectory (from diagnosis to remission);
- cancer recurrence;
- and survival and mortality rates.
- There is little data on breast cancer in the various Black communities across Quebec. But there are data from places such as Ontario (for black women) and the United States. They show differences between Black people and other ethnocultural groups in terms of the number of new cases of breast cancer (incidence), diagnosis and mortality rates.
Considering these disparities and the importance of early detection, the Quebec Breast Cancer Foundation has made it its mission to raise awareness across all communities by tailoring its content specifically to different ethnocultural backgrounds.
Breast Cancer in Black Women
- For those aged 50 and under in Ontario and the United States, the number of new cases of breast cancer is higher among Black women than White women. However, the number of new cases of breast cancer is slightly higher among White women of all ages (128/100,000 women versus 125/100,000 Black women).
- Black women are at a higher risk of being diagnosed with breast cancer:
- Triple negative: a more aggressive form of the disease. It is diagnosed twice as often in Black women as in White women.
- Metastatic: A more advanced form, where the cancer has spread to other parts of the body. Black women are more likely to be diagnosed with this type of cancer, are younger at diagnosis and have poorer survival rates compared with other ethnocultural groups.
- Breast cancer recurrence rates in the U.S. are also higher in Black women.
- Mortality rates from breast cancer in the U.S. and Canada are about 40% higher among Black women compared with all ethnocultural groups.
- Systemic factors
- Lack of information and awareness about breast cancer.
- Lack of educational and visual materials aimed at Black communities.
- Lack of prioritizing early detection over other priorities (work, family, other illness, etc.).
- Experiences of discrimination or racism in the healthcare system.
- Lack of representation of Black people in the healthcare system.
- Lack of cultural knowledge among healthcare professionals about Black experiences and health.
- Lack of access to appropriate care and delays in treating Black patients.
- Fear associated with immigration status (relating to health status and the impact of a possible breast cancer diagnosis).
- Lack of inclusion of Black patients in breast cancer studies in Canada.
- Biological/genetic factors
- Age. most breast cancer cases are diagnosed between the ages of 50 and 69 in all ethnocultural groups; however, for Black women, there is a higher incidence in women aged 50 and under than for White women (approximately 30% of new breast cancer diagnoses in Black women compared with 20% in White women).
- Certain mutations found in Black women are different from those usually found in White women. Some of these could explain why there is a higher proportion of triple-negative breast cancer and diagnosis under the age of 50 in Black women. These genetic mutations include: BRCA1, BRCA2, TP53, ARHGEF38, DARC, RASSF1A, RARβ, HIN-1, Cyclin-E, TERT-CLPTM1L, ANKLE1, Duffy, Kaiso.
- Psychological and sociocultural factors
- Cultural or religious beliefs related to breast cancer screening.
- Fear of pain and discomfort during mammography.
- Language barriers, which limit the understanding of breast cancer awareness, prevention and treatment.
- Socio-economic factors
- Canadian women from lower socioeconomic backgrounds and/or from an immigrant background have some of the lowest rates of mammography screening in Canada.
- Barriers to screening due to costs and logistics (taking time off, access to a doctor or clinic, etc.)
Everyone is at risk of developing breast cancer. Breast cancer is multifactorial, meaning that several risk factors contribute to the development of the disease.
However, it is possible to develop breast cancer even if you have no known risk factors.
Most risk factors can affect anyone, regardless of ethnocultural background. For more details on each of the risk factors, see the section Breast cancer risk factors.
Adopt a healthy lifestyle to minimize your risk of breast cancer:
- Limit alcohol consumption.
- Be physically active (150 minutes of moderate physical activity or 75 minutes of vigorous activity per week).
- Limit sedentary activities (sitting or lying down for long periods of time).
- Eat a healthy and varied diet based on Canada’s Food Guide.
- Don’t smoke, or quit smoking, and limit your exposure to second-hand smoke.
For more details, see the following section: Breast cancer prevention.
Knowing your risk factors and trying to minimize them is a good habit for preventing breast cancer. Unfortunately, many of the risk factors mentioned above cannot be changed.
It is therefore important to ask a doctor to assess your personal risk to determine if any particular prevention strategies are required:
- Discuss the pros and cons of hormone treatments and how to adapt them based on your level of risk.
- Discuss your family history and whether you should be referred for genetic counseling.
See our resources: Genetics and Breast Cancer—Ruban rose.
- Depending on your genetic risk, discuss options for preventive (prophylactic) surgery, as well as appropriate screening strategies (age, frequency, other tests). It may be a good idea for women from Black communities to start screening before the age of 50, particularly if a person has several of the risk factors mentioned above (genetic mutations, family history, etc.).
The following breast cancer risk assessment tools have been validated for Black people:
This said, physicians remain the main resource for assessing patients and making individual recommendations.
1. Chest/breast observation:
Chest/breast observation is a simple and easy way to help detect breast cancer at an early stage.
It involves carefully examining the appearance of the breasts both by touch (palpation to identify the presence of a lump, differences in breast size, changes in texture, etc.) and visually (changes in size, prominent nodes, the presence of visible hollows or lumps, changes in color or texture, discharge from the nipple, etc.).
Examining your breasts regularly helps you get to know your body better so that you can identify any unusual or persistent changes in your breasts that may warrant a visit to a healthcare professional.
It is important to know the signs typically associated with breast cancer and to be on the lookout for any changes in your breasts.
The most common sign is a lump or swelling of the breast that isn’t painful.
Other possible signs of breast cancer that should alert you:
- Bulge
- Hollow (retraction), dimples or folds in the skin of the breast or chest
- Enlarged lymph nodes
- Recent change in breast size or shape
- Unilateral, spontaneous nipple discharge (without stimulation)
- Recent nipple retraction (turned inwards)
- Persistent crusting, scaling, eczema or ulceration of the nipple
- Thickening or hardening of the skin or breast tissue (orange peel appearance)
- Recent change in the color of the skin, nipple or areola. For black or brown skin, the skin of the breast could appear darker, or red or purple
- Purplish skin or new, more visible veins.
- A feeling of heat or a burning sensation in the breast or chest
If you notice any of the above-mentioned signs or if you have any doubts, it is important to see a healthcare professional as soon as possible.
If you’re feeling anxious about a sign you’ve noticed or about having a mammogram, or if you have questions about breast cancer, don’t hesitate to call our free, confidential peer helpline: 1 855 561-ROSE.
2. Follow breast cancer screening recommendations:
Screening mammography:
- Screening mammography is a simple test to detect the presence of tumours in breast tissue. A screening mammogram can be done regardless of breast size. Mammograms are currently recommended for women aged 50 to 74 under the Quebec Breast Cancer Screening Program (PQDCS).
- Don’t hesitate to discuss your personal risk with your healthcare professional to determine the need for a personalized screening strategy (starting before age 50, more frequently than every two years, etc.).
Breast Cancer in Black Men
- Black men may show higher incidences (new cases over a period of time) of breast cancer compared to white men.
- From 2010 to 2016, in the United States, Black men had a 52% higher incidence rate of breast cancer compared to White men (2.75 vs. 1.81 per 100,000 men).
- Black men are diagnosed with breast cancer at a younger age compared to white men.
- The higher incidence rates in Black men span across all breast cancer subtypes.
- Black men have a higher incidence of hormone-receptor positive (HR+) cancers than White men across all age groups.
- Black men tend to be diagnosed with higher prevalence of hormone-negative (ER- and PR-) breast cancer compared to white men.
- Black men have a higher incidence of Triple-Negative Breast Cancer (an aggressive type of cancer) compared to White men.
- Black men with HR+ tumors tend to have lower survival rates compared to men from other racial/ethnic backgrounds.
- Black men are more likely to be diagnosed with more aggressive tumor types compared to white men.
- Black men are more likely to be diagnosed at advanced stages compared to white men, with higher tumor grades and higher prevalence of distant metastatic cancer. This can limit treatment options.
- Black men tend to experience poorer outcomes and prognosis compared to white men. The data indicates incidences of lower survival rates and higher mortality risk compared to White men.
- Specific systemic factors
- Disparities in screening delays.
- Lack of access to appropriate care and treatment.
- Systemic factors verified for black women that may apply to black men
- Lack of educational and visual materials aimed at Black communities.
- Experiences of discrimination or racism in the healthcare system.
- Lack of representation of Black people in the healthcare system.
- Lack of cultural knowledge among healthcare professionals about Black experiences and health.
- Fear associated with immigration status (relating to health status and the impact of a possible breast cancer diagnosis).
- Lack of inclusion of Black patients in breast cancer studies in Canada.
- General systemic factors—concerns all men
- Lack of awareness that breast cancer could affect men.
- Gaps in patient-provider communication.
- Training and education gaps among healthcare professionals on male breast cancer.
- Biological/genetic factors
- Age. Black men tend to be diagnosed with breast cancer at a younger age.
- Family history of breast cancer and genetic predispositions, particularly related to BRCA2 mutations.
- Sociocultural and psychological factors
- Concerns about the perception of masculinity following a breast cancer diagnosis.
Everyone is at risk of developing breast cancer. Breast cancer is multifactorial, meaning that several risk factors contribute to the development of the disease.
However, it is possible to develop breast cancer even if you have no known risk factors.
Most risk factors can affect anyone, regardless of ethnocultural background. For more details on each of the risk factors, see the section Male Breast Cancer.
Adopt a healthy lifestyle to minimize your risk of breast cancer:
- Limit alcohol consumption.
- Be physically active (150 minutes of moderate physical activity or 75 minutes of vigorous activity per week).
- Limit sedentary activities (sitting or lying down for long periods of time).
- Eat a healthy and varied diet based on Canada’s Food Guide.
- Don’t smoke, or quit smoking, and limit your exposure to second-hand smoke.
For more details, see the following section: Breast cancer prevention.
Knowing your risk factors and trying to minimize them is a good habit for preventing breast cancer. Unfortunately, many of the risk factors mentioned above cannot be changed.
It is therefore important to ask a doctor to assess your personal risk to determine if any particular prevention strategies are required:
- Discuss the pros and cons of hormone treatments and how to adapt them based on your level of risk.
- Discuss your family history and whether you should be referred for genetic counseling.
See our resources: Genetics and Breast Cancer.
- Depending on your genetic risk, discuss options for preventive (prophylactic) surgery, as well as appropriate screening strategies (age, frequency, other tests). It may be a good idea for men from Black communities to start screening earlier, particularly if a person has several of the risk factors mentioned above (genetic mutations, family history, etc.).
There are many different signs during the development of breast cancer to be aware of: Male Breast Cancer.
It is important to note that changes or lumps may be caused by benign conditions. When in doubt, please consult a general practitioner or a specialized nurse. During the consultation, the health professional may perform a clinical examination, assess your personal risk of breast cancer or prescribe diagnostic tests if deemed necessary.
If you have questions or concerns about the signs and symptoms of breast cancer, contact a healthcare professional or call the Peer Support Helpline at 1 855 561-PINK (7465). You can also consult our directory of services for resources specific to your needs.
To learn more about breast/chest health best practices, download or order our free educational material.
Available resources
- Breast cancer information: Information on risk factors, diagnosis, treatment and progression of breast cancer applies to the entire population. See the “Inform me” section of the website.
- Peer support line: 1 855 561-PINK;
- Psychosocial support: For people with breast cancer and their loved ones; soutien@rubanrose.org
See the Foundation’s resource directory for more details, under the “Support me” section of the website.
We would like to thank the Congolese Women Network and the Côte-des-Neiges Black Community Association for their help in reviewing the content on this page.
Breast Cancer in Black Women Sources :
- American Cancer Society. More Black Women Die from Breast Cancer Than Any Other Cancer. February 14, 2022:2022 Cancer Facts & Figures Cancer for African American/Black People | More Black Women Die from Breast Cancer Than Any Other Cancer | American Cancer Society
- Bassey-Archibong BI, Hercules SM, Rayner LGA, Skeete DHA, Smith Connell SP, Brain I, Daramola A, Banjo AAF, Byun JS, Gardner K, Dushoff J, Daniel JM. Kaiso is highly expressed in TNBC tissues of women of African ancestry compared to Caucasian women. Cancer Causes Control. 2017 Nov; 28(11):1295–1304. doi: 10.1007/s10552-017-0955-2. Epub 2017 September 8. PMID: 28,887,687; PMCID: PMC5681979.
- Black Women Health Imperative. What You Need to Know About Breast Cancer Now… Part 1 of a 3-part series with Dr. Lisa Newman—Black Women’s Health Imperative (bwhi.org); October 10, 2018
- Black Women Health Imperative. What You Need to Know About Breast Cancer Now… Part 2 of a 3-part series with Dr. Lisa Newman—Black Women’s Health Imperative (bwhi.org); October 16, 2018
- Black Women Health Imperative. What You Need to Know About Breast Cancer Now… Part 3 of a 3-part series with Dr. Lisa Newman—Black Women’s Health Imperative (bwhi.org); October 26, 2018
- Breast Cancer Research Foundation, AACR 2024 Breast Cancer Disparities | Breast Cancer Research Foundation (bcrf.org);June 6, 2024
- Glazier RH, Creatore MI, Gozdyra P, Matheson FI, Steele LS, Boyle E, Moineddin R. Geographic methods for understanding and responding to disparities in mammography use in Toronto, Canada. J Gen Intern Med. 2004 Sep; 19(9):952-61. doi: 10.1111/j.1525-1497.2004.30270.x. PMID: 15,333,060; PMCID: PMC1492521.
- Global Citizen. How This Toronto Hospital Is Improving Black Women’s Access to Breast Cancer Screening (globalcitizen.org). August 29, 2022
- Haiman CA et al. (2011) A common variant at the TERT-CLPTM1L locus is associated with estrogen receptor-negative breast cancer. Nat Genet 43(12):1210–1214
- Han Y, Miao ZF, Lian M, Peterson LL, Colditz GA, Liu Y. Racial and ethnic disparities in 21-gene recurrence scores, chemotherapy, and survival among women with hormone receptor-positive, node-negative breast cancer. Breast Cancer Res Treat. 2020 Dec; 184 (3):915–925. doi: 10.1007/s10549-020-05902-0. Epub 2020 Sep 14. PMID: 32,929,567; PMCID: PMC7658025
- Hanson K, Montgomery P, Bakker D, Conlon M. Factors influencing mammography participation in Canada: an integrative review of the literature. Curr Oncol. 2009 Sep; 16(5):65–75. doi: 10.3747/co.v16i5.359. PMID: 19,862,363; PMCID: PMC2768512
- Healthline. Breast cancer—Symptoms and causes—Mayo Clinic
- Howlader et al. (2017) SEER Cancer statistics review, 1975–2014. National Cancer Institute, Bethesda
- Mehrotra J et al. (2004) Estrogen receptor/progesterone receptor-negative breast cancers of young African-American women have a higher frequency of methylation of multiple genes than those of Caucasian women. Clin Cancer Res 10 (6) : 2052–2057
- National Institutes of Health. Gene variants and breast cancer risk in Black women | National Institutes of Health (NIH); June 4, 2024
- Newman LA, Martin IK (2007) Disparities in breast cancer. Curr Probl Cancer 31(3):134–156
- Nnorom SO, Akinyemi O, Tran J, Baig H, Cornwell EE 3rd, Frederick WA, Wilson LL. Color or money? : The impact of socioeconomic status and race/ethnicity on breast cancer mortality. Am J Surg. 2022 Dec; 224 (6):1403–1408. doi: 10.1016/j.amjsurg.2022.07.013. Epub 2022 Aug 24. PMID: 36,115,705
- Nnorom SO, Wilson L L. Breast Cancer in Black Women: Racial/Ethnic Disparities Affecting Survival. J Women’s Health (Larchmt). 2022 Sep; 31(9):1255–1261. doi: 10.1089/jwh.2021.0113. Epub 2022 Feb 28. PMID: 35,230,169.
- The Olive Branch of Hope. Triple-Negative Breast Cancer Among Black Women (theolivebranch.ca); April 18, 2022
- The Olive Branch of Hope. Why Are Women of African Ancestry At A Higher Risk of Breast Cancer? —The Olive Branch of Hope; June 7, 2022
- Vahabi et al. A population-based study in Ontario, Canada Cancer Medicine Open Access Screening Disparities by World Region of Origin. Cancer Med 2016; 5:1670—1686
- Yedjou CG, Tchounwou PB, Payton M, Miele L, Fonseca DD, Lowe L, Alo RA. Assessing the Racial and Ethnic Disparities in Breast Cancer Mortality in the United States. Int J Environ Res Public Health. 2017 May 5; 14(5):486. doi: 10.3390/ijerph14050486. PMID: 28,475,137; PMCID: PMC5451937
Breast Cancer in Black Men Sources :
- Anderson, W.F., Althuis, M.D., Brinton, L.A. et al. (2004). Is Male Breast Cancer Similar or Different than Female Breast Cancer? Breast Cancer Res Treat 83, 77–86. https://doi.org/10.1023/B:BREA.0000010701.08825.2d
- Chavez-MacGregor, M., Clarke, C.A., Lichtensztajn, D., Hortobagyi, G.N. and Giordano, S.H. (2013), Male breast cancer according to tumor subtype and race †. Cancer, 119:1611—1617. https://doi.org/10.1002/cncr.27905
- Goodman, M. T., Tung, K.-H., & Wilkens, L. R. (2006). Comparative Epidemiology of Breast Cancer Among Men and Women in the US, 1996 to 2000. Cancer Causes & Control, 17(2), 127–136. doi:10,100 7/s10552-005-5384-y
- Parise, C. A., Caggiano V. (2023). The association of race/ethnicity in male breast cancer survival within similar comorbidity cohorts. Cancer. 129 (5): 750–763. doi:10.1002/cncr.34592
- Sighoko, D., Rauscher, G., Murphy, A. M. (2017). Male breast cancer: are there racial disparities in incidence and tumor characteristics?. Medical Research Archives, [S.l.], v. 5, n. 4. ISSN 2375-1924. https://esmed.org/MRA/mra/article/view/1182
- Sung, H., DeSantis, C., Jemal, A. (2020). Subtype-Specific Breast Cancer Incidence Rates in Black versus White Men in the United States, JNCI Cancer Spectrum, Volume 4, Issue 1, February pkz091, https://doi.org/10.1093/jncics/pkz091
- Thomas, E. (2010). Original Research: Men’s awareness and knowledge of male breast cancer. Am J Nurs.; 110 (10):32-7, 39–40; quiz 41-2. doi: 10.1097/01.NAJ.0000389672.93605.2f. PMID: 20,885,124.
- Yadav, S., Karam, D., Bin Riaz, I., Xie, H., Durani, U., Duma, N., Giridhar, K.V., Hieken, T.J., Boughey, J.C., Mutter, R.W., Hawse, J.R., Jimenez, R.E., Couch, F.J., Leon-Ferre, R.A. and Ruddy, K.J. (2020), Male breast cancer in the United States: Treatment patterns and prognostic factors in the 21st century. Cancer, 126:26—36. https://doi.org/10.1002/cncr.32472