Disparities Observed Among Minority Women with Breast Cancer

Non-Hispanic whites more likely to be diagnosed with less advanced stages of breast cancer.

Previous studies have consistently reported disparities among minority women, specifically African Americans, Hispanic whites and American Indians, and non-Hispanic white women in regards to diagnosis and treatment of breast cancer.

This research addressed the disparities by stage of disease and survival rates, but did not characterize them by subtypes.

A recent study based on data from 18 US population-based cancer registries participating in the Surveillance, Epidemiology, and End Results (SEER) program evaluated data that included demographic characteristics; stage; tumor grade and size; primary treatment; health insurance status; tumor subtypes; hormone receptor status; and human epidermal growth factor 2-neu (HER2) status of 102,064 US women.

Non-Hispanic white women were found to be more likely to have smaller tumors and less-aggressive HR+/HER2-subtype of breast cancer while African American women were more likely to have large tumors and more aggressive triple-negative breast cancer.

African Americans were also 40 to 70% more likely to be diagnosed at stage 4 of all subtypes of breast cancer, and non-Hispanic white women were 30 to 40% more likely to be diagnosed at stage 2 or 3.

The disparities continued across all stages of the disease. Non-Hispanic whites compared with all other demographics were more likely to be diagnosed with less advanced stages of breast cancer, researchers found.

Additionally, they found that compared with non-Hispanic white women, African American women were 30 to 60% more likely to receive inappropriate treatment across all subtypes except HR-/HER2+, and Hispanic white women were 20 to 40% more likely to receive non-guideline concordant care.

However, compared with non-Hispanic white women, Asians and Pacific Islanders showed no disparity in receiving guideline-concordant care. Disparities persisted when accounting for insurance status, suggesting that other factors may be at play.

“We found that there is a consistent pattern of late diagnosis and not receiving recommended treatment for some racial and ethnic groups across all breast cancer subtypes,” the study authors wrote.

Recently, increased information about the molecular and genetic characteristics of breast cancer has aided in creating more effective treatment for the disease.

“The treatment for breast cancer is currently dependent on the type of breast cancer, defined by the estrogen receptor, progesterone receptor, and HER2 status,” the authors continued. “This is the reason why we think it’s important to look at the disparities by subtype. Given the racial and ethnic disparities, targeted, culturally appropriate interventions in breast cancer screening and care have the potential to reduce the disparities and close the existing survival gaps.”