The Who, What, Where, When and Sometimes, Why.

Race and Ethnicity

Rates of breast cancer in the U.S. vary by race and ethnicity.

White women and Black women have the highest incidence of breast cancer (rate of new breast cancer cases) overall [317]. American Indian and Alaska Native women have the lowest incidence (see Figure 2.3 below) [317].

Figure 2.3

 Figure 1.7 and 2.3 Breast Cancer Incidence in U.S. By Race and Ethnicity

Source: SEER Cancer Statistics Review, 1975-2017, 2020 [317]

Learn about differences in breast cancer rates in the U.S. and around the world.

Lifetime risk of breast cancer by race and ethnicity

The lifetime risk of breast cancer for women in the U.S. is about 13 percent [3]. However, this risk varies by race and ethnic group.  

Race and ethnicity

Lifetime risk of breast cancer

White

13%

Black

12%

Asian and Pacific Islander

11%

Hispanic

11%

American Indian and Alaska Native

8%

Source: SEER Cancer Statistics Review, 1975-2017, 2020 [3].

 

Why are there differences in breast cancer rates?

One reason behind differences in breast cancer rates may be that the prevalence rates of some risk factors for breast cancer vary by race and ethnic group [10].

Known risk factors that vary by race and ethnicity include [318-327]:

For example, white women are more likely than women of some other ethnicities (including Black and Hispanic women) to have children at a later age, to have fewer children and to use menopausal hormone therapy [10,320,322-323,326-327]. These factors are linked to an increased breast cancer risk [10].

Learn more about rates of breast cancer by race and ethnicity.

Black and African American women

Overall, Black women have a slightly lower rate of breast cancer compared to white women [317].

However, there are differences by age [655]:

  • Among younger women, Black women have higher rates of breast cancer compared to white women.
  • Among older women, white women have higher rates of breast cancer compared to Black women.

For example, in 2018, among women ages 15-39, the incidence of breast cancer in Black women was 26.3 per 100,000 women and the incidence of breast cancer in white women was 22.8 per 100,000 women [655].

The reasons behind this are under study. They may include differences in prevalence rates of some reproductive and lifestyle factors related to breast cancer risk as well as differences in tumor biology [318-327].

Age at diagnosis

Black women tend to be diagnosed at a younger age than white women [653].

The median age at diagnosis for Black women is 60, compared to 64 for white women [653].

Triple negative breast cancer (TNBC)

Prevalence rates of triple negative breast cancer (TNBC) differ by race and ethnicity.

TNBC is:

  • Estrogen receptor-negative (ER-negative)  
  • Progesterone receptor-negative (PR-negative)  
  • HER2-negative  

TNBC is more common among Black and African American women than among women of other ethnicities [326,328-332]. TNBC may also be more common among Hispanic women compared to white and non-Hispanic white women [333-335].

TNBC is often aggressive. TNBC is more likely than estrogen receptor-positive (ER-positive) breast cancers to recur, at least within the first 5 years after diagnosis [326,336-338].

Possible reasons for differences in rates of TNBC

Although the reasons for racial and ethnic differences in rates of TNBC aren’t clear, some lifestyle factors may play a role [339].

Compared to white and non-Hispanic white women, Black and African American women tend to [119-120,323,339,340-341]:

Both of these factors may be linked to an increased risk of TNBC [119-120,323,339,340-341].

Women with certain reproductive and lifestyle factors may have a lower risk of ER-positive breast cancers, but not a lower risk of ER-negative breast cancers, including TNBC [69-71,119,323,340].

Black and African American women may be more likely than white women to have protective factors that may not be linked to the risk of TNBC as much as they are linked to the risk of ER-positive cancers.

For example, Black and African American women are more likely than white and non-Hispanic white women to [119,323,340-343]:

  • Have more children
  • Be a younger age at first childbirth
  • Be overweight or obese before menopause

Although these factors are linked to a lower the risk of breast cancer, this lower risk may be limited to ER-positive breast cancers [69-71,119,323,340]. There’s even some evidence these factors may be linked to an increased risk of TNBC [69-71,119,323,340].

These topics are under study.

Learn more about the molecular subtypes of breast cancer.

Learn more about rates of breast cancer by race and ethnicity.

Updated 06/09/21