Breast Cancer

Breast cancer is the second leading cause of 

cancer deaths among women in the United States 

(2005-2009). Breast cancer deaths are going 

down the fastest among white women compared 

to women of other races and ethnicities. Black 

women have the highest death rates of all racial 

and ethnic groups and are 40% more likely to die 

of breast cancer than white women. The reasons 

for this difference result from many factors 

including having more aggressive cancers and 

fewer social and economic resources. To improve 

this disparity, black women need more timely 

follow-up and improved access to high-quality 

treatment.

Nearly 1,800 fewer black women 

would die of breast cancer if 

death rates were the same as 

white women. 

1,800

Black Women Have Higher Death Rates 

from Breast Cancer Than Other Women

40%

Black women are 40% more 

likely to die of breast cancer than 

white women.

Nearly 40,000 women die of 

breast cancer each year in the US.

40,000

See page 4

Want to learn more? Visit

November 2012

 www http://www.cdc.gov/vitalsigns

National Center for Chronic Disease Prevention and Health Promotion 

Division of Cancer Prevention and Control
Problem

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Differences in screening, 

follow-up, and treatment

SCREENING: 

Black women get mammograms as often 

as white women.

◊ Screening means looking for cancer before 

symptoms appear. Mammograms are the best way 

to screen for breast cancer. A mammogram is an 

X-ray picture of the breast. 

◊ Black and white women reported equal breast 

cancer screening in 2010 (mammograms every 2 

years for women 50 to 74: 74% versus 73%). 

(http://www.cdc.gov/cancer/breast/statistics/

screening.htm).

◊ More black women are found to have breast cancer 

that has spread beyond the breast (45%) compared 

with white women (35%).

FOLLOW-UP: 

Black women get follow-up care later than 

white women.

◊ When a mammogram shows something is not 

normal, follow-up tests are needed to see if it 

is cancer.

◊ More black women experience follow-up times of 

over 60 days (20%) compared with white women 

(12%) after a mammogram that is not normal.

◊ Waiting longer for follow-up care may lead to 

cancers that spread beyond the breast and are 

harder to treat.

TREATMENT: 

Black women have different treatment 

experiences than white women.

◊ After cancer is found, treatment should start as soon 

as possible.

◊ Only 69% of black women start treatment within 30 

days (compared with 83% of white women).

◊ Fewer black women receive the surgery, radiation, 

and hormone treatments they need compared to 

white women.

◊ Black women have 9 more deaths per 100 breast 

cancers diagnosed compared to white women.

Number of Additional Breast Cancer Deaths 

Among Black Women, By State

Compared with white women, 

for every 100 breast cancer cases, 

black women had

Difference could not be calculated

About the same number of deaths (DE, NE, RI)

3-8 more deaths

FL

NY

UT

ID

KS

NC

AR

IN

MI

AK

HI

AZ

CO

NE

MT

WY

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AL

WI

NM

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TX

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WV MD DC

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9 more deaths (US average)

10-12 more deaths

SOURCE: National Program of Cancer Registries, 

the National Cancer Institute’s Surveillance, 

Epidemiology and End Results Program and National 

Vital Statistics System Mortality Data (2005-2009)
WOMEN DOCTORS AND NURSES

Breast Cancer Screening,

Diagnosis and Treatment

1. Before testing (screening)

◊ Know if you should be tested and why.

◊ Know the right age to start getting tested.

◊ Make an appointment with your doctor, or find one, 

to talk about the test.

◊ Talk with your doctor or nurse about any concerns.

◊ Have close friends and family support you in 

getting tested.

◊ Schedule your mammogram appointment, taking 

work, home, language, and getting there 

into account.

1. Before testing (screening)

◊ Have a good clinic record system that reminds you 

which patients are due for testing.

◊ Talk with each patient about her risk of breast 

cancer, the benefits and risks of testing, and the 

right age to start testing.

◊ Answer questions from your patient about her 

concerns—costs, cultural barriers, fears, etc.

◊ Identify where she can get the test done.

◊ Have the office staff remind your patient of her 

upcoming appointment.

2. Getting a mammogram test

◊ Keep your appointment.

◊ If the doctor does not call you back in a week, call 

the office to ask for the results.

2. Getting a mammogram test

◊ Help your patient understand what she needs to do 

during the test.

◊ Answer her questions before and during the test.

◊ Get results quickly and promptly call your patient.

3. If the 1st test suggests cancer

◊ The results may be normal, not normal, or somewhere 

in-between. Try not to panic or worry. 

◊ Ask what the mammogram results mean.

◊ If the results are not normal, a breast ultrasound or 

biopsy may be recommended. Talk with your doctor 

and nurses about the results and the next steps.

◊ Make and keep follow-up appointments.

◊ Ask your close friends and family for support.

3. If the 1st test suggests cancer

◊ If possible, assign a patient navigator to 

your patient. 

◊ Talk with your patient about the next set of tests.

◊ Answer questions about your patients’ concerns.

◊ Refer her promptly for the next test or to the 

next doctor.

◊ Remind your patient of her upcoming appointments.

◊ Schedule a follow-up appointment, regardless of the 

results of the next test.

4. If the doctor tells you it’s cancer

◊ Ask all the questions you want. The doctor, nurse, 

and staff are there to help you understand and make 

good decisions about next steps.

◊ Expect to be referred to a cancer specialist who will 

discuss the best treatment options and take over 

your care for a while. 

◊ Ask your close friends and family for support. 

4. As soon as you know it’s cancer

◊ Know the next step(s) and why they are needed. 

◊ Refer your patient promptly to a cancer specialist.

◊ Keep track of her progress so she continues to see 

the cancer specialist(s) and gets all necessary therapy.

◊ Work with a patient navigator, if possible.
4

 www http://www.cdc.gov/vitalsigns

 www http://www.cdc.gov/mmwr

For more information, please contact 

Telephone: 1-800-CDC-INFO (232-4636)

TTY: 1-888-232-6348

E-mail: cdcinfo@cdc.gov

Web: www.cdc.gov

Centers for Disease Control and Prevention

1600 Clifton Road NE, Atlanta, GA 30333

Publication date: 11/27/2012

What Can Be Done

Federal government is

◊ Implementing the Affordable Care Act and 

educating women about the preventative benefits 

and coverage provided by the law, including 

coverage of mammograms without co-pays in 

many health plans and, beginning in 2014, the law 

will expand access to health insurance coverage for 

30 million previously-uninsured Americans.

◊ Investing in the use of electronic health records 

and case management services in federally-funded 

health clinics so women get the timely followup care. For example, over $80 million were 

invested to help networks of health centers adopt 

electronic health records (EHR) and other health 

information technology (HIT) system.

◊ Supporting state efforts, through the National 

Breast and Cervical Cancer Early Detection 

Program, to help uninsured women get screening 

and access to treatment. 

◊ Supporting research on health disparities in 

breast cancer.

State and local health agencies can

◊ Use public-private partnerships to work with 

health care systems and health insurance 

companies to help educate women and their 

doctors about timely, high-quality breast cancer 

care.

◊ Use outreach strategies to help women understand 

why they need a mammogram. 

◊ Educate women on what to expect when a 

mammogram finds something that is not normal. 

Health care systems can

◊ Engage well-trained case managers, health 

educators, community health workers and other 

patient navigators to help women understand and 

guide them through the health care system.

◊ Inform doctors about their screening and 

treatment rates to improve their timeliness of care.

◊ Explore strategies to enhance doctor-patient 

communications.

Doctors, nurses, and others 

who treat patients can

◊ Make sure that women get recommended tests 

and treatments.

◊ Use tools like electronic systems or other 

reminders to notify patients when it’s time to 

get a mammogram.

◊ Continue to talk to women about their risk for 

breast cancer, explain test results and refer 

patients to specialists as needed.

Women can

◊ Use these 10 questions to increase their 

communications with their doctor during 

appointments. (http://www.ahrq.gov/questions/

tenquestions.htm). 

◊ Get recommended mammograms.

◊ Contact their local health department or 

community health center for help if they cannot 

afford a mammogram. (http://www.cdc.gov/

cancer/nbccedp/screenings.htm). 

◊ Return for more tests if a mammogram finds 

something that needs follow-up.

◊ Ask about the kinds of treatment available.

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