Thank you.
The first point I want to make is about family history, as you've heard a couple of times. It's very important that everyone understand that—sit down for this one—85% of women who get breast cancer have no family history. Women are at increased risk if they do, but that's not the only risk factor. The other omission has been that Black, Asian and Hispanic women especially are at risk of developing cancer younger, but there are other groups who are at high risk, like Ashkenazi Jewish women.
The reason that mortality is so terrible in Black women is that they're at a much higher risk of getting these rapidly moving triple-negative cancers. For that reason, Black women are 40% more likely to die if they do get breast cancer.
Those are the aggressive, fast-moving cancers. The way to find them as early as possible is not only to do the mammogram every year, but if a woman has dense breasts—and that's more common in Black women—they should also get supplemental screening. Whether that's with ultrasound or MRI should depend on their actual risk level, which can be determined with online risk calculation tools that are easily accessible with just a few questions.
A Black woman with dense breasts and a family history is probably going to be at a high enough risk to justify not only screening her younger, but screening her more often and with better technology, like MRI.