For decades, Black women in the United States have faced a disproportionately higher risk of dying from breast cancer compared to women of other racial groups. But a growing body of research, coupled with advancements in genetic testing, is beginning to shift the landscape, offering more targeted treatments and, crucially, improved survival rates. Recent studies highlight the importance of genomic profiling in identifying aggressive subtypes of breast cancer that are more prevalent in Black patients, paving the way for personalized medicine and a narrowing of the survival gap.
The disparity isn’t simply a matter of later diagnosis, though access to timely screening remains a critical issue. It’s rooted in the biological characteristics of the tumors themselves. Historically, most breast cancers were categorized broadly based on hormone receptor status (estrogen and progesterone) and HER2 protein expression. However, within the hormone receptor-positive, HER2-negative (HR+/HER2-) subtype – the most common form of breast cancer – significant heterogeneity exists. Newer genomic profiling tests are revealing distinct subtypes within this category, some of which are particularly aggressive and more common in Black women, according to research published in Breast Cancer Research and Treatment.
Uncovering Aggressive Subtypes
Researchers have identified specific genomic signatures associated with poorer outcomes in Black women with HR+/HER2- breast cancer. These signatures often indicate a more proliferative and aggressive tumor biology, meaning the cancer cells are dividing and growing rapidly. “What we’re learning is that not all HR+/HER2- breast cancers are created equal,” explains Dr. Lisa Newman, a surgical oncologist at Henry Ford Health System, in a recent interview with Rolling Out. “There are distinct subtypes that behave very differently, and these differences are particularly important when considering treatment strategies.”
Genomic profiling, such as Oncotype DX, MammaPrint, and Prosigna, analyzes the expression of multiple genes within a tumor sample. This provides a more nuanced understanding of the cancer’s behavior and helps predict its response to different therapies. Traditionally, all HR+/HER2- patients were often treated with endocrine therapy alone. However, genomic profiling can identify patients who would benefit from the addition of chemotherapy, even within this subtype. A study published by Business Wire found that genomic profiling can identify aggressive tumor subtypes driving racial survival disparities in HR+/HER2– early-stage breast cancer.
The Impact of Genetic Testing on Treatment and Survival
The increased utilize of genomic profiling is already showing promising results. Studies demonstrate that Black women who undergo genomic testing are more likely to receive chemotherapy when appropriate, leading to improved outcomes. “We’re seeing a clear correlation between genomic testing and more personalized treatment plans,” says Dr. Newman. “This is particularly important for Black women, who historically have been underrepresented in clinical trials and may not have benefited from the same advances in treatment as other groups.”
The benefits extend beyond chemotherapy decisions. Genomic profiling can also help identify patients who are less likely to benefit from certain therapies, sparing them from unnecessary side effects. It can guide the selection of targeted therapies that specifically address the unique characteristics of their tumor. According to a report from Reuters , genetic testing is improving treatment and survival for Black breast cancer patients.
Addressing Barriers to Access
Despite the clear benefits, access to genomic profiling remains a challenge for many Black women. Cost, insurance coverage, and geographic location can all be barriers. Advocacy groups are working to increase awareness of genomic testing and advocate for broader insurance coverage. Efforts are also underway to improve access to genetic counseling, which can help patients understand the results of genomic testing and develop informed decisions about their treatment.
“We need to ensure that all women, regardless of their race or socioeconomic status, have access to the tools and resources they need to fight breast cancer,” emphasizes Dr. Reid, a leading voice in addressing racial disparities in breast cancer care. “Genomic profiling is a powerful tool, but it’s only effective if it’s available to everyone who could benefit from it.” Devdiscourse reports that genetic testing is a breakthrough in breast cancer survival disparities.
Looking Ahead
The future of breast cancer treatment for Black women is increasingly focused on precision medicine – tailoring treatment to the individual characteristics of each patient’s tumor. Ongoing research is exploring new genomic markers and developing even more sophisticated profiling tests. Clinical trials are also underway to evaluate the effectiveness of novel therapies targeting specific subtypes of breast cancer. The goal is to continue narrowing the survival gap and ensure that all women have the best possible chance of beating this disease.
The National Today reports that genomic profiling reveals aggressive tumor subtypes driving racial survival gaps.
The next key step involves expanding access to genomic profiling and integrating these results into routine clinical practice. The American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN) continue to update their guidelines to reflect the latest research on genomic testing and personalized treatment. Patients are encouraged to discuss genomic profiling with their oncologists to determine if it’s right for them.
If you or someone you know is affected by breast cancer, please reach out to the American Cancer Society (https://www.cancer.org/) or the National Breast Cancer Foundation (https://www.nationalbreastcancer.org/) for support and resources. Share this article to help raise awareness about the importance of genetic testing and personalized medicine in the fight against breast cancer.
