De Jesus Elizabeth M, Elmore Leisha C, Fayanju Oluwadamilola M
Division of Breast Surgery, Department of Surgery, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA, USA.
Penn Center for Cancer Care Innovation, Abramson Cancer Center, Philadelphia, PA, USA.
Ann Surg Oncol. 2025 Sep 3. doi: 10.1245/s10434-025-18157-0.
Breast cancer mortality rates have declined steadily over the past 40 years, as enhanced screening has shifted the balance of new diagnoses to curable, early-stage cancers while advances in systemic therapy have yielded improved and increasingly durable outcomes even for locally advanced and metastatic disease. However, this reduction in mortality has not been equitably distributed among all racial groups, and there continue to be significant racial and ethnic disparities. In this review, we summarize research that has contributed to our understanding of disparities in breast surgical oncology across all racial/ethnic groups, however, given that the most egregious disparities exist among Black women, our review will involve considerable focus on this racial group. We will discuss racial disparities across the breast cancer continuum including access to care, diagnosis, surgical treatment, and survivorship and will conclude with strategies to redress them.
在过去40年里，乳腺癌死亡率稳步下降，这是因为强化筛查已将新诊断病例的平衡转向可治愈的早期癌症，而全身治疗的进展即使对于局部晚期和转移性疾病也带来了更好且日益持久的治疗效果。然而，这种死亡率的降低在所有种族群体中分布并不均衡，种族和族裔差异仍然显著。在本综述中，我们总结了有助于我们理解所有种族/族裔群体在乳腺外科肿瘤学方面差异的研究，不过，鉴于最严重的差异存在于黑人女性中，我们的综述将大量聚焦于这个种族群体。我们将讨论乳腺癌连续过程中的种族差异，包括获得医疗服务、诊断、手术治疗和生存情况，并将以纠正这些差异的策略作为总结。
