White women are more likely to receive a diagnosis of breast cancer, but African American women have a higher mortality rate. The mortality rate for breast cancer for African American women is about 31 per 100,000 women compared to 22 per 100,000 white women. On the other hand, Hispanic, Asian/Pacific Islander, and American Indian/Alaska Native women have lower mortality rates compared to white women.
One reason for the difference in mortality among African American women may be that young African American women are disproportionately affected by triple-negative breast cancer. There is no targeted treatment for this subtype. It lacks the receptors for estrogen, progesterone and human epidermal growth factor receptor-2 (HER-2) and cannot be controlled with drugs such as tamoxifen or Herceptin that target these receptors. There are fewer effective treatment options for these patients, however it appears that chemotherapy may be more effective in this type of breast cancer.
Sociodemographic variables, such as income and education level, and behavioral and cultural differences have also been implicated in survival disparities. Research has also indicated that lower rates of adequate surgical, radiation, and systemic therapy among African American women, and higher rates of delays between diagnosis and treatment, as well as premature discontinuation of primary and adjuvant therapy, may contribute to poorer survival. However, studies have also found that survival disparities persist even in settings with equal access to health care for all women. It is not clear if all women are receiving equal treatment in these settings.