While there are significant gaps in local data because ethnicity coding in health services is poor, in Wessex breast late-stage diagnosis was highest among Black or Black British patients (23.1%) and Asian or Asian British patients (17.1%), compared to White British women (9.2%) (Taylor, 2025). Future improvements in ethnicity coding will ensure a more accurate picture of prevalence and differences in stage of diagnosis.

Local data also shows that breast cancer patients from minoritised ethnic groups are being diagnosed at slightly younger ages than white patients. There were no clear local patterns of later diagnosis related to deprivation, although future age standardised data sets may present a different picture.

National and local data and insight tell us that later diagnosis may be because:

• Black and Asian women experience more barriers to breast screening, and are therefore less likely to attend
• Because some get the disease younger, they would not be eligible for screening at the time of diagnosis
• Health information, including for breast cancer, is more likely to reflect white women’s experiences so may not reach or resonate with Black and Asian women
• Black and Asian women may not see themselves as at risk of developing the disease, or know their family history
• Black women are more likely to have to see their GP more than once before being referred
• There may be mistrust in health care because of experiences of racism. Black and Asian women may feel ignored and unheard because of behaviours, attitudes and assumptions made by clinicians and health staff. Staff can lack awareness regarding some presentations of breast cancer in Black and Asian women e.g. skin discolouration etc.
• A wide range of cultural, religious or other beliefs can determine whether Black and Asian women will seek health care advice early, including fear, stigma and taboo in discussing cancer, believing cancer is a punishment or contagious; and/or that they may put their fate in the hands of their faith. Deprioritising their own health for the sake of family and the household may also play a part, as well as fears about the financial, emotional and other impacts of getting a cancer diagnosis
• Practical reasons like being able to take the time to book and go to an appointment may also be a barrier, as well as perceptions about how easy it would be to get an appointment

There are also issues in terms of Black women’s experiences of breast cancer care and support, as highlighted by Black Women Rising’s survey of 100 women and the subsequent film Unseen Unheard, about six different women’s experiences.

A summary of the issues, include a lack of:

• Appropriate wigs and prosthetics
• Visibility in, and culturally appropriate, patient information
• Cultural awareness by breast care teams
• Psychological and / or peer support