Dr Narayan on Variations in Breast Cancer Outcomes by Race

Anand Narayan, MD, PhD, associate professor, vice chair, Equity, Department of Radiology, Section of Breast Imaging, the University of Wisconsin (UW) School of Medicine and Public Health, member, the UW Health Breast Center, discusses how outcomes differ between different subgroups of patients who are diagnosed with breast cancer, highlighting how these differences tie back to disparities in cancer care.

When assessing various parameters, notable disparities become evident among distinct patient subgroups, Narayan begins. Firstly, within the context of racial or ethnic subpopulations, substantial racial disparities emerge, he says. Specifically, individuals of Black or AfricanAmerican descent exhibit an approximately 40% higher breast cancer mortality rate than White patients, Narayan explains. This disparity has persisted within this domain for several decades, with limited progress in addressing it. Additional disparities are related to language proficiency, as people for whom English is not their primary language experience significant gaps in cancercare delivery, Narayan emphasizes.

Across breast cancer screening services, several disparities are notably pronounced in rural areas, where access to screening facilities is often limited and high-quality facilities are scarce, Narayan eludes. Furthermore, individuals lacking health insurance or facing underinsurance encounter significant gaps and delays in care, predisposing them to advanced cancer diagnoses, he notes. 

Across these diverse domains, as well as within certain subsets, substantial care gaps and delays are evident, Narayan expands. For instance, within Asian populations, which are broad and encompass a diverse spectrum of individuals with distinct backgrounds and cultural contexts, reduced mammography screening rates are observed, he says. Moreover, within this population, significant variations in screening rates are noted based on patients’ ethnic origins.

Considering these disparities and the diversity among patients with cancer, it is imperative that cancer centers tailor their screening and treatment approaches to cater to the unique needs of patients, both within local medical contexts and across the broader regions of the United States, Narayan continues. This process entails a thorough understanding of patients’ individual histories and experiences, which can help design services that adequately center patients’unique perspectives and ensure equitable access to care that respects their lived experiences both as individuals and within historically marginalized groups, Narayan concludes.