Disparities in screening and diagnosis for triple negative breast cancer

October 22, 2021
Clinic corridor in a hospital

Breast cancer is the most common cancer in the US and the most frequent cancer among women.

Of these diagnoses, approximately 10%–20% of breast cancers are diagnosed as the triple negative subtype (TNBC). The majority of TNBC cases occur in younger women under the age of 60. The relative incidence of the TNBC subtype is higher among racially diverse groups, and particularly Black women, and these groups are diagnosed at later stages of the disease more often than white women. The difference in the distribution of the TNBC subtype may be partly attributable to biological factors resulting from racial differences, such as tumor heterogeneity and gene expression. However, differences in socioeconomic status and social determinants of health can lead to differences in comorbidities such as obesity and diabetes, which, alone and in interaction with biological risk factors, may also affect the prevalence and trajectory of TNBC in Black, Hispanic, and low-income women.

Gilead Sciences asked Charles River Associates and Tigerlily Foundation to examine the extent to which policies associated with triple negative breast cancer (TNBC) screening and diagnosis can exacerbate or ameliorate disparities in TNBC health outcomes among underserved populations in the United States (US). In particular, the objective was to:

  • Describe evidence of the impact that social determinants of health and differences in access to screening and diagnosis have on TNBC patients’ survival and
  • Highlight how health policies in the US can support patient access to timely screening and diagnosis.

To do this, CRA conducted a comprehensive literature review of the TNBC policy landscape, evaluating the extent to which screening and diagnosis policies and programs for TNBC patients support the needs of underserved populations and reduce health disparities and inequities (HDI). This evaluation was enhanced by integrating insights from patient advocacy group Tigerlily to capture the real-world patient perspective and experience.

We focused on federal, state, and community-level policies and programs. The analysis covered six states—California (CA), Georgia (GA), Louisiana (LA), Massachusetts (MA), Michigan (MI), Pennsylvania (PA)—and included additional states with constructive policy examples. The states of focus were selected based on their high level of breast cancer incidence among Black women, whether they are considered a key leader in policy action, and to ensure regional representation across the US.

To read more about our findings and evaluations, please download a copy of our report.

This report was conducted for and funded by Gilead Sciences Inc.

Additional authors