RESEARCHERS have identified that Black women in the United States have significantly higher breast cancer mortality rates than White women across all tumour subtypes, despite advancements in early detection and treatment.
A comprehensive search of databases was conducted to identify studies published between January 2000 and December 2022, comparing breast cancer survival among Black and White women. Studies were selected based on their focus on tumour subtypes characterised by hormone receptor and HER2/neu (now ERBB2) status. The analysis included 18 studies involving 228,885 patients, with 34,262 Black women and 182,466 White women. Random-effects models were used to combine individual study results, producing pooled relative risks (RRs) and 95% confidence intervals for breast cancer–specific survival and overall survival (OS).
The analysis revealed that Black women had a higher risk of breast cancer mortality than White women across all tumour subtypes. Specifically, Black women with hormone receptor-positive HER2-negative tumours had a 50% higher risk of mortality (RR:1.50), while those with hormone receptor-positive/HER2-positive tumours had a 34% higher risk (RR:1.34). Black women with hormone receptor-negative/HER2-positive tumours showed a 20% higher risk (RR:1.29), and those with hormone receptor-negative/HER2-negative tumours had a 17% higher risk of death (hazard ratio:1.17). Additionally, overall survival was poorer for Black women across all tumour subtypes.
The findings indicate that racial disparities in breast cancer survival are both subtype-specific and independent of tumour biology. Addressing these disparities will require multilevel interventions, including improved access to early detection, equitable healthcare delivery, and targeted therapies. Clinical practice should focus on tailoring treatments to these disparities while working toward broader systemic changes to achieve health equity. Further research into the underlying mechanisms driving these outcomes is crucial for guiding future interventions.
Katrina Thornber, EMJ
Reference
Torres JM et al. 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;DOI:10.1200/JCO.23.02311.
