African-American women are more likely to die from breast cancer than women of any other race or ethnicity. And when found, their tumors are often at an advanced stage, leaving fewer treatment options.

Since early detection is key, Dr. Robin A. Skrine, an African-American breast surgeon, shares her tips and suggestions with theGrio.com on self-breast exams and breast cancer screening in African-American women.

“[African-American women] tend to get breast cancer earlier and more aggressive,” says Skrine, who is in private practice at Lone Star Breast Care in Fort Worth, Texas. “It’s not that it presents differently, it’s just that we have to start being aware at an earlier age.”

Get a baseline examination.

Skrine suggests having your regular doctor or gynecologist perform a breast examination annually starting at age 20. Once the doctor confirms that the breasts are normal, for the next two weeks, examine the breasts every day.

“At the end of those two weeks, you will know your breasts,” Skrine says.

Look for changes.

“Get to know your breasts like a road map,” Skrine says. She instructs women to look at their breasts in the mirror with hands on hips and then arms overhead. Feel the breasts in two positions — sitting and laying down — in the shower or even while watching television.

“What you’re looking for is any change in your breast,” she explains. “A change in your breast shape or nipple, or any discharge.”

If you find a change or a lump?

You can give it a week or two, Skrine says, or wait a full menstrual cycle. If it persists, go to the doctor.

Get screened earlier.

Because African-American women are diagnosed with more aggressive breast cancer at younger ages, screening should occur earlier.

“It’s not that [the women] have been ignoring it, its just that it’s fast growing,” says Skrine. “We have to do our due diligence sooner.”

The current recommendation is to start screening mammograms at age 40. But, with a strong family history — a first-degree relative or several second-degree relatives with breast cancer — a woman could potentially have at least one screening mammogram between ages 35 and 40.

“It’s going to be hard to justify an annual mammogram on a woman under 40, because that’s not the recommendation. But, if there’s another reason to follow you closely, insurance should cover it,” Skrine explains.

Diet and exercise

Lifestyle, include diet and exercise, plays a large role in the development of many cancers, including cancer of the breast.

“In our population, there are a disproportionate amount of women who are overweight,” says Skrine. “Diet, exercise, maintaining healthy weight, that’s something we have direct control of.”

She adds that moderation when it comes to alcohol and smoking is also important.

Be proactive.

Skrine encourages women to be aware of their family history and risk, and be proactive about their health and screening for breast cancer.

“Don’t be afraid of breast cancer,” she says. “Do the best you can. Get the care you need.”

Dr. Tyeese Gaines is a physician-journalist with over 10 years of print and broadcast experience, now serving as health editor for MSNBC’s theGrio.com. Dr. Ty is a practicing emergency medicine physician in New Jersey and clinical instructor of emergency medicine at Yale School of Medicine. Follow her on twitter at @doctorty.