October is Breast Cancer Awareness Month. You'll see a lot of pink this month, but the most useful thing we can share is information, especially the facts that apply to us.
Black women are less likely to be diagnosed with breast cancer than white women, yet more likely to die from it. That gap isn't inevitable. Much of it comes down to when cancer is found and how quickly we get care. Knowing your screening schedule, knowing what's normal for your body and speaking up early are three things you can start this month.
Why does breast cancer affect Black women differently?
According to the American Cancer Society, Black women have a 38% higher breast cancer death rate than white women. Several things contribute:
- Later diagnosis. Black women are more likely to be diagnosed at a later stage, when cancer is harder to treat.
- More aggressive types. About 19% of breast cancers in Black women are triple-negative, compared with roughly 9% to 11% in other groups. Triple-negative breast cancer tends to grow faster and has fewer targeted treatment options.
- Younger age at diagnosis. Black women are diagnosed at about 60 on average, compared with 64 for white women.
- Access gaps. Differences in insurance, follow-up after an abnormal result and timely treatment all play a part.
None of this is meant to scare you. It's the reason screening on time matters so much for us.
When should I start getting mammograms?
For women at average risk, the U.S. Preventive Services Task Force recommends a mammogram every two years from age 40 to 74. In 2024, the Task Force lowered the starting age from 50 to 40, in part because more women are being diagnosed in their 40s and because Black women are more likely to die from breast cancer at younger ages.
Your provider may suggest starting earlier, screening more often or adding other imaging if you have:
- A mother, sister or daughter who had breast or ovarian cancer, especially before 50
- A known genetic mutation, such as BRCA1 or BRCA2
- Dense breast tissue
- Past radiation to the chest
Not sure where you fall? Ask. It's one of the most important questions you can bring to your next appointment.
What changes should I watch for?
Get to know how your breasts normally look and feel, so you notice when something is different. See a provider promptly if you notice:
- A new lump or thickening in the breast or underarm
- A change in the size, shape or skin of the breast, such as dimpling or puckering
- Skin that looks darker, red or textured like an orange peel
- A nipple that turns inward, or discharge that isn't breast milk
- Pain in one spot that doesn't go away
Most breast changes turn out not to be cancer. Every change still deserves to be checked, and you never need to wait for your next routine visit to call.
What should I ask my provider?
Bring these to your next visit, or save them to your phone:
- Based on my family history and health, when should I start screening, and how often?
- Do I have dense breasts? If so, do I need additional imaging?
- Should I talk to a genetic counselor?
- If something shows up on my mammogram, what happens next, and how quickly?
- If cost is a concern, what screening programs or resources can help?
If you feel rushed or brushed off, it's okay to say so, ask for a referral or get a second opinion. We share more on finding a provider who listens in Finding the Right OB-GYN for Black Women.
What if I can't afford a mammogram?
Most insurance plans cover screening mammograms without a copay. If you're uninsured or underinsured, the CDC's National Breast and Cervical Cancer Early Detection Program offers free or low-cost screening in every state. Find a screening program near you.
Frequently asked questions
Do I need a mammogram if no one in my family has had breast cancer?
Yes. Most people diagnosed with breast cancer don't have a family history. Routine screening is recommended for women at average risk starting at 40.
Are breast self-exams still recommended?
Formal monthly self-exams are no longer a standard recommendation, but knowing what's normal for your body is. If you notice a change, don't wait: call your provider.
Is a mammogram painful?
It can be uncomfortable for a few seconds while the breast is compressed. If you can, schedule it for the week after your period, when breasts tend to be less tender.
Share this with someone you love
The best thing you can do this month is book your own screening, then send this to a sister, mother, auntie or friend who needs the reminder. Taking care of each other is how we close the gap.
Sources: American Cancer Society, Breast Cancer Facts & Figures 2024, as reported by AJMC; U.S. Preventive Services Task Force, Breast Cancer: Screening (2024); CDC, National Breast and Cervical Cancer Early Detection Program.
This article is for informational purposes and is not medical advice. It cannot diagnose any condition. Talk to a qualified healthcare provider about your breast health, screening schedule or any changes you notice. Full disclaimer.
