Cancer prevention researcher and recently-hooded PhD graduate Dr. LaShae Rolle recently went public with a harrowing personal story about being a 26-year-old Black woman diagnosed with breast cancer after initially being dismissed by her providers due to her age.
For me, a young Black woman and fellow cancer prevention researcher, this story hits home. I am a graduate research assistant at the University of Maryland, College Park, and I recently coordinated an event to spotlight early onset breast cancer in the Black community. In the planning process, I realized personally I knew three Black women, beloved mentors and family friends, who were diagnosed with breast cancer in their 20s and 30s. That realization, and testimonies like Dr. Rolle’s, underscored that for the Black community the surging incidence of early onset breast cancer is more than just numbers – it’s a crisis affecting our neighbors, colleagues, mentors, friends and sisters.
Early-onset breast cancer is on the rise. According to the Centers for Disease Control and Prevention, breast cancer diagnoses in women under 45 increased 1.1% per year from 2012 to 2022. Young Black women face even higher risk, with nearly twice the odds of being diagnosed with breast cancer compared to young White women, according to a 2024 study in JAMA Network Open.
Moreover, young Black women have an elevated risk of triple negative breast cancer, an aggressive, fast-growing subtype, and ultimately face a 50% higher chance of dying from it compared to young women of other races, even when accounting for tumor characteristics and treatment, according to a 2025 study published in The American Journal of Surgery.
The reasons for these inequities are still being studied, but cancer researchers suspect a combination of genetic and social factors. For instance, research shows women between 25 and 49 facing provider dismissiveness and diagnostic bias in seeking cancer screening due to their age, including delays or even denial of access to mammography despite presenting symptoms or having family history or other reasonable concern. These practices contribute to early-onset breast cancer cases being detected at advanced, harder-to-treat stages. This problem is magnified for young Black women, who disproportionately perceive discrimination and provider mistrust when seeking breast health care, according to researchers at Virginia Commonwealth University, who found that Black women with breast cancer had seven times the odds of reporting incidences of discrimination when compared to White women with breast cancer. But the medical profession still lacks clear recommendations for us.
I’ve conducted over a dozen Cancer Health Ambassador trainings, UM Greenbaum Comprehensive Cancer Center’s standard program that educates the general public in cancer awareness. I have planned multiple peer education events specifically regarding young adult cancer education through a health equity lens; and I am writing my dissertation on adapting the center’s existing Cancer Health Ambassador training for Black women ages 18 to 39. So I know that educational programs administered by academic centers, non-profits, or community organizations are critical to enhancing breast cancer knowledge and awareness among young women. But few widely accessible educational programs are both age-adapted for young women and culturally tailored to Black women.
This needs to change. Leading cancer organizations must reevaluate the screening guidelines to include women under 40, the American Cancer Society’s recommended age to start mammography, with particular attention to younger Black women. This should include clearer information on breast self-exams or “breast awareness” recommendations clearly targeted to young women, and stricter guidelines requiring medical professionals to provide women with mammograms if reasonable concern is presented, even if they are below 40. Awareness campaigns should include topics like breast anatomy, risk factors (especially young women-relevant ones, like hormonal birth control use), disparities, symptoms and self-advocacy in healthcare settings.
For young Black women, academic institutions, non-profit and community organizations, and medical associations must prioritize, increase funding, and scale up targeted educational programs nationwide. These should include compelling testimonies and imagery centered on young Black women; live and asynchronous delivery on social media elements, with toolkits to promote sharing information online with friends and family, and facilitation by other young Black women. In the Black community, word of mouth is a significant vessel for information. Telling a friend or family member – a sister, a daughter, a niece – what you read today is a powerful step to advancing breast health for young Black women.
These were the kinds of interventions young Black women said they wanted in a 2022 University of Maryland study. For decades, research has also demonstrated that culturally tailored approaches are especially effective in building breast cancer knowledge and awareness in Black women; these interventions ultimately support improved adherence to breast-healthy behaviors, with up to fourfold greater net increases in mammography adherence when compared to non-tailored interventions.
Dr. Rolle’s story echoes the stories of young Black women in our own lives. We must not wait any longer to demand breast cancer screening guidelines and educational resources designed to work for everyone.
Asli McCullers is a Research Specialist at MedStar Health Center for Health Equity Research, a 4th–year Behavioral and Community Health PhD Candidate at the University of Maryland, College Park, and a Public Voices Fellow on Youth Well-Being and Power with The OpEd Project and Hopelab.
