Unmasking the Divide: Racial Disparities in Breast Cancer Mortality as a Marker of Systemic Gaps in Surgical and Oncologic Access

Background and Objective: Breast cancer remains a leading cause of cancer related mortality in women, with significant disparities among ethnic groups. This study examines trends in breast cancer incidence and mortality in the U.S., focusing on racial disparities and areas for improving cancer control and equity. Methodology: Data from the SEER Program (2010–2022) was used to examine incidence rates based on race and age. Mortality trends from 1999 to 2020 were assessed using the CDC WONDER database, stratified by race. Results: Between 2010-2015, the overall incidence of HER2+/HR+ breast cancer showed an upward trend, which reversed from 2016-2022. Notably, Black women experienced the most statistically significant drop in incidence during 2018-2022, with an Annual Percent Change of -2.3% (p value: 0.02%). Age-specific analyses revealed a significant rise in women aged 50-64 and 65+ from 2010-2016, followed by a decline with Annual Percent Changes of -1.9% and -2.0%, respectively. Racial trends reflect a shift from rising to falling incidence, particularly in older age groups, signaling potential improvements in prevention and early detection. The Age-Adjusted Mortality Rate (AAMR) among Black women declined notably from 27.58 in 2010 to 22.74 in 2020, but remained considerably higher than other groups. In comparison, 2020 AAMRs were 15.69 for White women, 9.75 for Asian women, and 8.56 for American Indian women. Conclusion: Despite improvements in breast cancer incidence, disparities in mortality persist, highlighting the need for transdisciplinary solutions. Collaboration across oncology, surgery, and public health is vital to address systemic gaps and ensure equitable healthcare access for all, particularly marginalized racial groups.