Disparities in Breast Cancer Diagnosis, Treatment, and Outcomes Among South Asian American Women

Abstract

Simple Summary Breast cancer is the most common cancer diagnosed in women, yet certain populations remain underrepresented in research. South Asian Americans, individuals of Indian, Pakistani, Bangladeshi, and related heritage, are the fastest-growing immigrant population in the United States, but how breast cancer affects them is not well understood, in part because they are frequently combined with the broader Asian American category, which can obscure meaningful differences. Using a large national cancer database, we examined nearly 2.4 million women diagnosed between 2004 and 2021 to compare South Asian American women with white women in terms of tumor characteristics, treatment, and survival. We observed that South Asian American women were diagnosed at younger ages, more frequently presented with aggressive forms of the disease, and experienced longer delays before starting treatment. Despite these factors, they demonstrated more favorable long-term survival, although delays before surgery were associated with higher mortality. These findings underscore the importance of further investigating breast cancer risk, treatment access, and outcomes among South Asian American women. The younger age at diagnosis, higher frequency of aggressive tumor subtypes, and longer time to treatment observed in this population suggest potential opportunities to refine screening approaches and reduce barriers to timely care. Understanding the biological, clinical, and sociodemographic factors underlying their favorable survival outcomes may help inform more equitable and culturally responsive strategies for breast cancer prevention, diagnosis, and treatment.