Findings

Black women have a higher incidence of breast cancer before the age of 40, more severe disease at all ages, and elevated mortality risk compared to white women. In 2012, Black women had a breast cancer mortality rate that was 42% higher than that of their white counterparts [8].

Figure 1. Differential roles of gender relations and sex-linked and race biology on health outcomes according to various sources, particularly the CDC.

Biological Risk Factors

Gender Relations: not a determinant of risk factor Sex-linked/Race Biology:

Biological Identification as a Woman

From the CDC website: “The main factors that influence your risk include being a woman and getting older” [2]. Reproductive History

Having the first pregnancy after age 30, not breastfeeding, and never having a full-term pregnancy [2]. Genetic Mutations

Black patients with breast cancer that are of African ancestry are more likely to have pathogenic variants in a cancer susceptibility gene than non-Hispanic white patients [3].

Black women are more likely to have subtypes of breast cancer tumors that are more aggressive, more resistant to treatment, and that do not have clear molecular targets for treatment [8].

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Figure 2. Differential roles of gender relations and racialization on health outcomes.

Socioeconomic Risk Factors

Gender Relations: lack of a primary care provider, childcare issues, location, transportation [1] Racialization: high levels of stressors in living and working environments for greater duration and intensity, lack of insurance, cost of health care [1,8]

Behavioral Risk Factors

Gender Relations: embarrassment from breast exposure during mammograms, perceptions of homophobia, higher prevalence of smoking and alcohol use, low oral contraceptive use [1,6] Racialization: skepticism, mistrust, perceptions of racism, negative experiences within the health care system [1]