The American Cancer Society estimated more than 19,000 black women would be diagnosed with breast cancer this year -- the second-most common cancer among black women, surpassed only by lung cancer.

And while the incidence of breast cancer is about 12 percent lower in black women than in white women, with black women, it often strikes at an earlier age, and the mortality rate is higher.

Since October is Breast Cancer Awareness Month, many women schedule their annual mammograms during the month to make it easier to remember. Others make mammogram appointments on or near their birthdays.

The bottom line, though, is black women should be checked early and regularly.

According to the Society’s “Cancer Facts & Figures for African-Americans 2007-2008” booklet, “Factors that contribute to the higher death rates among African-American women include differences in access to and utilization of early detection and treatment, risk factors that are differentially distributed by race or socio-economic status, or biological differences associated with race.”

But it’s not just a matter of access to health care. Even after accounting for income and access to strong health care, “Poorer outcomes among African-American women persist. ... There is also evidence that aggressive tumor characteristics are more common in African-American women than white women.”

Netwellness.org reports, “Statistics show that overall, when African-American women are diagnosed, they have larger tumors and their breast cancer has spread further (i.e. to the lymph nodes and to other parts of the body).”

The five-year breast cancer survival rate for black women is 69 percent, compared with 84 percent for white women, according to the Web site. And while there has been an increase in the number of women getting both hand examinations from their doctors, as well as mammograms to check for lumps in their breasts, black women still tend to have fewer mammograms and are more likely to be diagnosed after the cancer has spread.

If that’s not enough to get you into a doctor’s office, consider this: Black women are also disproportionately prone to a rare, particularly virulent form of breast cancer that tends to strike women under the age of 35.

According to a study published in June 2006 in the Journal of the American Medical Association, black women under the age of 50 have a 77 percent higher mortality rate from breast cancer than other women of the same age.

The study, led by scientists at the University of North Carolina at Chapel Hill schools of Public Health and Medicine and the UNC Lineberger Comprehensive Cancer Center, said that younger, pre-menopausal black women are more prone to an especially aggressive type of cancer.

Tumors in the most common kind of breast cancer have excessive amounts of estrogen, progesterone or a protein called human epidermal growth factor receptor 2. A rare type of cancer, dubbed triple negative cancer, does not develop from any of the usual factors, and chemotherapy is not always effective in destroying the cancer.

In addition to UNC, researchers at Emory University and the University of Chicago are trying to determine the root cause of the cancer and why it strikes young black women decades before menopause, when most breast cancer develops.

And don’t forget to check the medical history of your father’s family.

In June, the Journal of the American Medical Association published the results of a study that revealed that a pattern of hereditary breast cancer may be hard to detect because a family is so small, or has so few female members that it doesn’t appear to be prevalent. However, the cancer gene can be passed on from the father’s side of the family, as well as the mother’s, because every person inherits half of her genes from her mother and half from her father.

Previously, doctors concentrated on a woman’s maternal family in assessing cancer risk. Now, physicians say, it is important to determine whether there is a history of breast cancer in women on the paternal side of the family as well.

The conventional wisdom for women, generally, has been that all women age 40 and older should have a mammogram every one to two years and that women over 20 should have a clinical breast exam every three years and should perform monthly self-exams.

Considering the more devastating potential for black women, however, many health professionals now recommend black women:

• Perform self-examinations monthly, starting at age 20.
• Have a clinical breast exam done by a doctor at least once a year.
• Have at least one mammogram between the ages of 30 and 35, then one every one to two years until age 50, when it should become an annual event.
• If your mother or sister had breast cancer, you should consider having regular mammograms before the age of 30.

If you don’t know where to go, visit the American Cancer Society’s site, www.cancer.org, type in your zip code and get a list of doctors and clinics near you or call 1-800-227-2345 to find out how to get a free mammogram.