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Human Rights Research Center
23 hours ago4 min read

Bridging the Gap: Addressing Age and Racial Inequities in Breast Cancer Outcomes

January 8, 2025


[Image Credit: National Breast Cancer Foundation, INC. at https://www.nationalbreastcancer.org/breast-cancer-facts/]

Breast cancer is a critical health issue in the United States, particularly among young women whose rates of diagnosis have risen through the years. It is the leading cause of cancer-related deaths in women under 45 years old, and its incidence and mortality rates are expected to increase in the coming years (Anastasiadi et al., 2017). For example, its incidence rose by 1% annually from 2012-2021, with a steeper increase for women under 50 at 1.4% (Giaquinto et al., 2024). However, research has focused almost entirely on women above the age of 40, leading to knowledge gaps on the unique challenges faced by younger populations (Tesch and Partridge, 2022). As a result, there is a lack of clear guidelines for breast cancer screening and treatment options for women under 40. The disparities in breast cancer outcomes are even more pronounced for Black women, who experience higher mortality rates than White women (Nnorom and Wilson, 2022). More comprehensive research is needed to address this public health concern to ensure better outcomes for women of all demographics.


In addition, more needs to be done to help younger women with their unique struggles with breast cancer, including psychosocial issues such as fertility preservation and job reintegration (Rossi et al., 2019). Existing research, mostly conducted on women over 40, has been generalized to this younger population. Without sufficient research, there are unclear standardized guidelines for screening younger populations; in turn, insurance companies will not cover this testing. Additionally, young women are more likely to have more aggressive forms of breast cancer that are diagnosed at later stages, have local recurrences, and require different treatment therapies that have not been sufficiently researched (Radecka, 2016). These under-researched treatments include fertility preservation and breast-conserving surgery, likely because breast cancer is treated as a disease that only affects older individuals. 


In addition, many of the breast cancer screening services available in the United States are limited to certain patient populations. Only those who have financial and geographic access to these services can use them. Residential segregation, stress, racism, discrimination, built environment, and social environment all impact healthcare access (Richardson and Norris, 2010). Additionally, race and ethnicity impact the presentation, treatment, and outcomes of breast cancer. For example, diagnostic mammograms for Black women tend to show larger, higher-grade tumors with lower rates of estrogen receptor and/or progesterone receptor positivity than those of other groups. (Yankaskas and Gill, 2005). Nevertheless, healthcare guidelines related to breast cancer screening are the same for all populations. Further research is needed to determine the differences in screening among these different groups. 


Regarding outcomes, Black women under 35 years old have breast cancer mortality rates that are three times greater than those of White women (Johnson et al., 2018). In addition, the 5-year survival rates of breast cancer are lowest for Black women among all racial and ethnic groups for every molecular subtype and stage of the disease except for stage 1 (Giaquinto et al., 2022). Further research should be conducted into the impact of race and ethnicity on the presentation of breast cancer, and healthcare providers should consider the implications of these differences on their patients’ care.


Access to quality healthcare is a fundamental human right, regardless of background or status. With rising rates of breast cancer among younger and racially diverse women, it is more urgent than ever to conduct targeted research into treatment options that address the distinct challenges these populations are facing and implement standardized screening guidelines for healthcare providers. 



 

Glossary


  • Estrogen Receptor Positivity: A breast cancer subtype involving cells in the breast tissue that bind to estrogen, which can cause cancer cells to grow.

  • Molecular Subtype: A group of cancers that share certain genetic changes of biomarkers.

  • Mortality Rate: The ratio of deaths compared to the overall population, caused by a particular case.

  • Progesterone Receptor Positivity: A breast cancer subtype involving cells in the breast tissue that bind to progesterone, which can cause cancer cells to grow.

  • Residential Segregation: The separation of different social groups into different residential areas based on characteristics like race, ethnicity, or income.


 

Sources


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  2. Giaquinto AN, Sung H, Miller KD, Kramer JL, Newman LA, Minihan A, Jemal A, Siegel RL. Breast Cancer Statistics, 2022. CA Cancer J Clin. 2022 Nov;72(6):524-541. doi: 10.3322/caac.21754. Epub 2022 Oct 3. PMID: 36190501. https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac.21754 

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