Persistent Disparities Across Age, Race, and Ethnicity Revealed in Recent Report on U.S. Breast Cancer Mortality Trends

Take-Away Points

• ■ Major Focus: To retrospectively analyze temporal trends in breast cancer mortality among U.S. women using National Center for Health Statistics (NCHS) data (1990–2022), stratified by age, race, and ethnicity.

• ■ Key Results: Breast cancer mortality among U.S. women declined by 43.5%, although progress slowed after 2010. Recent plateaus in mortality decline occurred among Asian, Hispanic, and Native American women with mortality rates increasing among Native American women and older Asian women. Mortality remained higher among Black women compared with White women, particularly in those younger than 40 years of age.

• ■ Impact: Persistent age and racial disparities underscore the need for targeted screening and treatment and improved access to care, particularly for populations where mortality rates have worsened or stalled.

Breast cancer remains the second leading cause of cancer-related death among U.S. women. In 2010, declines in breast cancer mortality among women under age 40 stalled, potentially due to limited screening access and increasing incidence of distant-stage disease at diagnosis. Stage IV breast cancer incidence has also risen among U.S. women overall, except for non-Hispanic White women.

Monticciolo and Hendrick used NCHS data (1990–2022) to retrospectively analyze trends in female breast cancer mortality by age, race, and ethnicity across three cohorts: all U.S. women; U.S. women aged 20–39, 40–74, and over 75 years; and U.S. women of all ages stratified by race and ethnicity. From 1990 to 2022, overall breast cancer mortality among U.S. women declined by 43.5% but showed slower improvement after 2010 (adenomatous polyposis coli = –1.23%). Decline in mortality among women aged 20–39 years plateaued after 2010, particularly among White and Hispanic women. For women aged 40–74 years, mortality continued to decline for most groups except Asian women, whose rates stabilized after 2011. Among women aged 75 years and older, mortality declines ceased after 2013 with rates stabilizing in White and Hispanic women, decreasing in Black women, and increasing in Asian women.

By race and ethnicity, mortality declined by 41.4% in White women, 30.3% in Hispanic women, 28.8% in Black women, and 11.8% in Asian women but increased by 10% in Native American women. Plateaus or reversals in mortality decline emerged for Asian, Hispanic, and Native American women in the mid-2000s, whereas steady declines persisted for Black and White women from the early to mid-1990s onward. Between 2004 and 2022, breast cancer mortality remained higher in Black than White women (ratio, 1.39) with the largest disparity among women aged 20–39 years (ratio, 2.04). A similar age-dependent disparity occurred in stage IV breast cancer incidence at diagnosis.

Although breast cancer mortality in the United States has decreased substantially since 1990, inequities persist across age and racial groups. These findings highlight the urgent need to enhance equitable access to screening, diagnosis, and treatment, particularly for populations where mortality trends have stagnated or worsened.

Highlighted Article

• Monticciolo DL, Hendrick RE. Recent Trends in Breast Cancer Mortality Rates for U.S. Women by Age and Race/Ethnicity. J Breast Imaging 2025;7(4):420–428. doi: https://doi.org/10.1093/jbi/wbaf007