
Social Disparities Increase Breast Cancer Mortality for Black Women
Key Takeaways
- Black women with breast cancer have a 40% higher mortality rate, influenced by social determinants and limited genetic research.
- Studies show worse outcomes for Black women, especially with HR+ and HER2- tumors, and higher T cell levels may impact survival.
Disparities in access to quality treatment and lack of equitable and inclusive data in breast cancer research contribute to poorer survival outcomes for Black women with breast cancer.
Black women with
Despite advancements in early detection, mammography, and breast cancer therapy, Black women face a high mortality rate from breast cancer that can be attributed to several external factors. The most prominent are social determinants of health and limited studies exploring genetic differences in the presentation of breast cancer in Black women.1,2
There are relevant studies that document the susceptibility rates and prevalence of breast cancer in Black women, but they do not explain the reason behind these findings. In a
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Yet, researchers of these studies overlooked genetic data in their findings, which may provide further insight into these disparities.
Genetic Differences Influencing Breast Cancer Mortality in Black Women
Black women are also twice as likely to develop and die from the aggressive subtype triple-negative breast cancer (TNBC). Yet, despite the drastic disparities in mortality and prognosis, the majority of genetic studies into breast cancer data have focused on women of European ancestry.4
However, a recent study in the journal
“At present, we do not know the underlying reasons, whether biological or social, for why Black women have higher abundances of certain immune cell populations, and this is a topic for future investigation,” the authors wrote in their study on T cell subsets in Black women with invasive breast cancer.
In response to the lack of breast cancer data from Black women, a research team from Vanderbilt University sought to better understand the unique genetic risk Black women have.5
“We have worked with researchers from more than 15 institutions in the US and Africa to establish this large genetic consortium,” Zheng, lead researcher at Vanderbilt University, said in a press release with the NIH.6 “Data put together in this consortium have been and will continue to be used by researchers around the world.”
Social Determinants of Health and Breast Cancer Development and Treatment
Higher mortality rates and low survival outcomes among Black women can be attributed to various factors like delays in diagnosis and inadequate access to timely, quality cancer treatments, which are also impacted by social determinants of health.1 The most relevant aspects are economic stability, access to quality health care, and the neighborhood and built environment.3
Yet, there are efforts to abate disparities in access to timely treatment. Another study sought to identify
However, despite these findings, Black women on Medicare or Medicaid and living in areas with a high neighborhood deprivation index (NDI) had significantly shorter relapse-free intervals (HR, 1.39; 95% CI, 1.0-1.84) and overall survival (HR, 1.49; 95% CI, 1.10-2.99) when compared with White women, even after adjusting for other covariates like NDI, insurance coverage, and early discontinuation of therapy.
When evaluated for contributing factors of survival disparities (demographics, comorbidities, insurance, tumor characteristics, and treatment), Black women aged 18-64 with stage I to III breast cancer had an excess mortality decrease from 105.1% to 24.9% when compared with White women, but differences in insurance status accounted for 37% of excess mortality.3 While these data suggest social determinants do play a role in survival disparities for Black women with early-stage breast cancer or HR+/HER2- breast cancer, they do not completely explain these disparities.
Combined influences of genetics and social determinants of health—more specifically, access to timely care—remain important factors when discussing the high prevalence, mortality risk, and treatment for Black women with breast cancer. While there are ongoing efforts to compile data for genetic studies to explain said disparities among Black women, further research is still needed to better equip patients with tailored chemotherapies to better address this demographic and improve outcomes.
References
1. Torres JM, Sodipo MO, Hopkins MF, Chandler PD, Warner ET. Racial differences in breast cancer survival between Black and White women according to tumor subtype: a systematic review and meta-analysis. J Clin Oncol. 2024;42(32):3867-3879. doi:10.1200/JCO.23.02311
2. Omilian AR, Mendicino L, George A, et al. Quantitative analysis of T cell subsets in a population of Black women with invasive breast cancer. Npj Breast Cancer. 2025;11(1). doi:10.1038/s41523-025-00780-5
3. Lovejoy LA, Shriver CD, Haricharan S, Ellsworth RE. Survival disparities in US Black compared to White women with hormone receptor positive-HER2 negative breast cancer. Int J Environ Res Public Health. 2023;20(4):2903. doi:10.3390/ijerph20042903
4. Gene variants and breast cancer risk in Black women. NIH. June 3, 2025. Accessed July 21, 2025.
5. Jia G, Ping J, Guo X, et al. Genome-wide association analyses of breast cancer in women of African ancestry identify new susceptibility loci and improve risk prediction. Nat Genet. 2024;56(5):819-826. doi:10.1038/s41588-024-01736-4
6. Gene variants and breast cancer risk in Black women. News release. NIH. June 4, 2024. Accessed July 26, 2025.
7. Chavez-MacGregor M, Lei X, Malinowski C, Zhao H, Shih YC, Giordano SH. Medicaid expansion, chemotherapy delays, and racial disparities among women with early-stage breast cancer. J Natl Cancer Inst. 2023;115(6):644-651. doi:10.1093/jnci/djad033
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