Hyuna Sung, PHD

Triple-Negative Breast Cancer: Racial and Ethnic Disparities Vary Between US States

MedicalResearch.com Interview with:

Hyuna Sung, PHDHyuna Sung, PHD
Senior Principal Scientist, Cancer Surveillance Research
American Cancer Society
Kennesaw, GA 30144


MedicalResearch.com: What is the background for this study?

Response: Triple-negative breast cancer (TNBC) accounts for 10% to 20% of all breast cancer diagnoses in the US.

This subtype of breast cancer tends to spread faster and has fewer treatment options. In the US, Black women are about two-fold more likely than White women to develop TNBC.

MedicalResearch.com: What are the main findings?

Response:  Across all states and racial and ethnic groups, there was over four-fold variation in Triple-negative breast cancer incidence rates ranging from less than 7 per 100,000 among Asian or Pacific Islander women in Oregon and Pennsylvania to greater than 29 per 100,000 among non-Hispanic Black women in Delaware, Missouri, Louisiana, and Mississippi.

Non-Hispanic Black women living in Delaware, Missouri, and Louisiana have a 2.2-fold increased risk of TNBC compared with their counterparts among non-Hispanic White women in the same state, experiencing substantially greater racial disparity than 1.4-fold in Colorado and Minnesota.

State variation within each racial and ethnic group is also substantial. Among non-Hispanic White women, rates are lowest in Utah (9 per 100,000) and highest in Iowa, Mississippi, and West Virginia (15 per 100,000).

MedicalResearch.com: What should readers take away from your report?

Response: The substantial state variation in TNBC incidence rates within and between racial and ethnic populations strongly suggests a role of social, environmental, and structural determinants of health in shaping the geographically patterned risk of TNBC.

MedicalResearch.com: What recommendations do you have for future research as a results of this study?

Response: One of the important limitations is that the state-level examination masks likely existing disparities in TNBC rates within each state. Similarly, using aggregated racial and ethnic classifications obscures disparities in subpopulations. Additional surveillance studies are needed to further characterize disparities at a more granular level and better inform prevention strategies.

Due to the descriptive nature of the study, the study does not answer the question of what factors have caused the substantial variations in state-level incidence rates of TNBC. The observation merits further studies with risk factor data at multiple levels and a rigorous ecosocial framework to better understand the associations of social exposures with the risk of TNBC.

Nothing to disclose.


Sung H, Wiese D, Jatoi I, Jemal A. State Variation in Racial and Ethnic Disparities in Incidence of Triple-Negative Breast Cancer Among US Women. JAMA Oncol. Published online March 02, 2023. doi:10.1001/jamaoncol.2022.7835

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Last Updated on March 9, 2023 by Marie Benz