A call for societal interventions to reduce the burden of breast cancer mortality among African American women

Background Socioeconomic status (SES) is a critical determinant of health disparities and may influence the incidence, prognosis, and biology of breast cancer. African American women (AAW) experience lower overall breast cancer incidence but disproportionately higher mortality rates, a disparity often attributed to a higher prevalence of estrogen receptor (ER)-negative breast cancers in this population. Objective To explore the role of SES in shaping disparities in breast cancer outcomes, particularly its potential contribution to the elevated risk of ER-negative breast cancer among AAW, and to highlight the protective role of breastfeeding. Methods This commentary synthesizes existing literature and epidemiological data to evaluate the interplay between SES, genetic susceptibility, and behavioral factors such as breastfeeding. Analytical emphasis is placed on disentangling social determinants from biological explanations of ER-negative breast cancer risk. Findings Evidence suggests that SES-related factors may contribute to the disproportionately high prevalence of ER-negative breast cancer among AAW. Additionally, breastfeeding may confer a protective effect against ER-negative cancer in women with children, offering a potentially modifiable factor to reduce risk. Conclusions SES inequalities may play a pivotal role in shaping breast cancer disparities beyond genetic predisposition. Addressing these inequities through targeted legal, educational, and public health interventions could reduce breast cancer burden and mortality in AAW.