Why Black women face high rates of breast cancer

The day before she turned 30 and had planned to leave for a celebratory vacation, Sharonda Vincent felt a lump on her left breast while in the shower. She scheduled a last-minute appointment with a doctor at Planned Parenthood, who told her to enjoy her trip because she doubted it was cancerous.

After Vincent returned home to Philadelphia, the mother of one decided to see her primary care provider, just in case. This led to a series of tests, including a mammogram, ultrasound and biopsy. In the summer of 2005, she was diagnosed with stage 2B breast cancer.

"I was numb, hurt, confused, upset, questioning God," she told TODAY. "It was a complete shock."

Vincent, now 45, has been cancer-free for 15 years, thanks to the surgery, chemo and radiation she underwent that summer. She's among the millions of Black women who've survived breast cancer, even though the odds are unjustly stacked against them.

Black women are 40 percent more likely to die from breast cancer than white women. Black women are also more likely to be diagnosed at a later stage or at a younger age. Death rates for white women with breast cancer are improving more rapidly than for Black women, according to the Centers for Disease Control and Prevention.

Research into the reason for these disparities is ongoing, but it's likely "multifactorial," Dr. Vivian Bea, chief of breast surgical oncology at New York-Presbyterian Brooklyn Methodist Hospital, told TODAY.

What's more, Bea expects breast cancer outcomes for Black women to only get worse due to COVID-19. A recent survey, conducted by the cancer information platform SurvivorNet, found that 1 in 3 women has delayed getting a mammogram because of the coronavirus.

A doctor who looks like you

As a physician and Black woman, Bea believes that a main inhibitor for the Black community to seeking health care is the absence of doctors who can relate to their life experiences. Only 5 percent of U.S. doctors are Black, and even fewer are Black women, per 2018 data.

"When I take care of my Black patients ... I can't tell you how often I hear, 'I trust you because you look like me," she said. "I hear stories of, 'I talked to this doctor, and I told them I had a mass, and they told me it was nothing,' or 'I had a pain, and they said it was in my head.' Unfortunately (Black) women are sometimes not taken seriously."

While Vincent doesn't feel her care team approached her differently because of her race, she said she leaned heavily on the only Black medical professional she encountered during her treatment.

In Vincent's initial appointments, she recalled, staff struggled to draw her blood, and she had to be pricked by multiple techs each time, especially uncomfortable given her fear of needles. So the Black medical assistant planned her future visits so the one tech who could draw Vincent's blood on the first try was always available.

"She made it a point to really get close to me," Vincent said. "It was almost like she rode this journey with me. She wanted to make sure I felt comfortable in the office. ... It made a big difference."

Suffering in silence

Shortly after Vincent was diagnosed, she found out her grandmother was going through radiation, the last leg of her own breast cancer treatment, but had never told anyone before.

"As close as we are, my grandmother didn't want to make it too known, so when she learned of my diagnosis, she felt she needed to be that shoulder for me," Vincent recalled. "We shared stories, and I actually used her surgeon."

Vincent suspects that her grandmother's approach is common among Black women. "People in Black families probably feel like, 'We have so much other stuff to worry about, let's not bog the family down with this news,'" she said.

Bea pointed out that she often hears Black women say, "I never had cancer in my family, so I'll never get breast cancer," but that's "totally not true," she stressed.

Tracy Tomer, diagnosed with stage 3A breast cancer in January, told TODAY that hearing from other Black women in her Brooklyn neighborhood that they had breast cancer was a revelation of sorts.

"We never know what other people are gong through until we sometimes are going through things ourselves," Tomer, 53, said. "In my community, I don't know if women talk to one another ... but when you start confiding in people, you find out what's going on with others. ... I never knew so many Black women were dealing with breast cancer. You start to think, well, what's going on in the community?"

Accessing quality care

Asked what aspects of the health care system she'd want to improve to better support Black breast cancer patients, Bea called out the lower quality of care that Black women often receive.

"The first step is making sure all providers who see any woman understand the standard of care that they deserve," she said. "What's the age that they should get a mammogram? Who should they be sent to? The answer is a specialist where they're treated in a multidisciplinary fashion, not your buddy down the street."

As Dr. Elizabeth Comen, a medical oncologist at Memorial Sloan Kettering Cancer Center in New York City and advisor to the cancer information platform SurvivorNet, explained it, "It's not just how quickly you get to a doctor, but are you getting to a doctor that knows how to treat your disease correctly?"

Comen also pointed out that medical professionals don't adequately seek out Black participants for breast cancer research, which limits the quality of their care. In 2019, Black people comprised only 4 percent of clinical trial subjects for oncology drugs that were later approved.

"A Black women might come to me and say, 'If you want to give me the new drugs, in a clinical trial how many Black women were treated by it?'" Comen explained. "In some instances, different ethnicities can have different side effects."

'Black breasts matter'

Vincent, Bea and Tomer all said that Black women tend to put other people's problems above their own — and that's why Vincent and Tomer hope talking about their diagnoses will encourage fellow Black women to prioritize their own health.

"We have a tendency (to think), 'Oh, it went away so I'm not going to worry about it,'" Tomer said, recalling the stinging sensation she felt in her breast two months before seeing a doctor. "I was like, 'I'll take care of everybody else. I'll be alright.'"

Bea added: "Black women's lives matter. They need to know that, and oftentimes they don't feel that way. ... Black breasts matter."

She went on to stress the importance of Black women conducting monthly breast exams and seeing their provider if they notice any changes, such as masses, nipple discharge, skin changes or swelling.

"Don't take no for an answer if you feel within your soul that something is wrong," she said.