A groundbreaking study from Queen Mary University of London has unveiled stark disparities in breast cancer outcomes among women of African and South Asian genetic ancestries compared to their European counterparts. Drawing on comprehensive clinical and genetic data from over 7,000 women with breast cancer, the research reveals that women from African and South Asian backgrounds not only develop breast cancer at younger ages but also face significantly higher mortality rates at earlier stages of life. These findings deepen our understanding of the biological and clinical heterogeneity of breast cancer across diverse populations and carry profound implications for precision oncology and public health policies.
Historically, breast cancer research and clinical trials have overwhelmingly focused on populations of European descent, representing nearly 80% of participants in genetic association studies despite comprising only 16% of the global population. This glaring imbalance has perpetuated a knowledge gap, where risk factors, prevention strategies, and treatment protocols are predominantly informed by European-centric data, potentially limiting their efficacy for women of other ancestries. The present study highlights the urgent necessity to diversify genetic and clinical research cohorts to capture the full spectrum of breast cancer biology and to develop equitable healthcare approaches.
Professor Claude Chelala and her team leveraged datasets from multiple large-scale initiatives, including the Breast Cancer Now Biobank, the 100,000 Genomes Project, the Genes & Health study, and the Cancer Genome Atlas. By integrating genetic sequencing and clinical records spanning women of African, South Asian, and European ancestries from both the UK and US, the researchers performed a detailed comparative analysis. Their multi-dimensional approach encompassed mutation profiling, clinical presentation timelines, survival data, and treatment responsiveness, providing a robust framework to dissect ancestry-specific patterns in breast cancer.
One of the study’s most striking revelations is the earlier age of diagnosis and mortality among women with African and South Asian genetic backgrounds. Compared to European women who typically receive diagnosis around age 50, South Asian women were diagnosed nearly seven years earlier, while African women saw diagnosis about five years earlier. More alarmingly, mortality data showed South Asian women died approximately thirteen years earlier and African women about nine years earlier than their European peers. These statistics challenge current NHS screening guidelines that recommend commencing breast cancer screening at age 50 across all populations, suggesting a critical need to tailor screening strategies based on genetic ancestry to enable timely detection.
At the molecular level, the researchers identified significant differences in mutation rates within key cancer susceptibility genes, including the well-characterized BRCA1 and BRCA2 genes. These genes, integral to DNA repair mechanisms, are crucial in assessing hereditary breast cancer risk and guiding targeted therapies. The study found distinct mutational landscapes in women from African and South Asian ancestries that could influence tumor behavior and therapeutic resistance. Notably, some patients harbored mutations that potentially conferred resistance to conventional treatments but were not accounted for during clinical decision-making, underscoring a gap in personalized medicine application.
These molecular disparities further complicate treatment efficacy and outcomes. Precision medicine—tailoring treatments based on individual genetic makeup—holds promise for revolutionizing cancer care. However, it fundamentally relies on a comprehensive understanding of genetic variations across diverse populations. The findings reveal that insufficient representation of non-European ancestries in research can lead to blind spots, risking suboptimal treatment regimens for underrepresented groups and exacerbating health disparities. Incorporating diverse genetic data into clinical algorithms is essential to unlock the full potential of precision oncology.
The study’s authors emphasize the necessity for larger, more ethnically diverse cohorts to validate these initial findings and to unravel the complex interplay of genetics, environment, and socio-economic factors in breast cancer disparities. They advocate for a paradigm shift in cancer research design, urging funders and scientific institutions to prioritize inclusivity and equity. Ensuring diverse ethnic representation in clinical trials and genetic studies is not merely an ethical imperative but a scientific necessity to achieve comprehensive insights and improve outcomes universally.
Beyond the scientific and clinical implications, the study also addresses systemic barriers that contribute to the underrepresentation of certain groups in research. Structural inequalities, mistrust in medical systems, language barriers, and limited access to healthcare resources often hinder participation from minority populations. Overcoming these challenges necessitates community engagement, patient advocacy, and culturally sensitive research practices. Collaborative partnerships between researchers and patient communities are pivotal to co-produce knowledge that reflects varied experiences and needs.
Balwinder Nanray, a patient advocate diagnosed with cancer in 2015, underscores the importance of individualized care and inclusive research. Her perspective highlights that cancer treatment transcends biological factors; it encompasses the recognition of patients as whole individuals with unique backgrounds and circumstances. Engaging patients in every step of the research process—from study design to dissemination—can lead to more effective, acceptable, and sustainable solutions that truly serve diverse populations.
The implications of this study extend to healthcare policy and clinical guidelines. Revising breast cancer screening protocols to incorporate ancestry-specific risk profiles could enhance early detection and reduce mortality disparities. Moreover, integrating genetic testing that reflects population-specific mutation spectra may enable oncologists to select more appropriate and effective treatment modalities, minimizing adverse responses and improving survival. The findings call for a concerted effort among clinicians, researchers, and policymakers to embed equity into the fabric of cancer care.
In conclusion, this pioneering research sheds light on the complex clinical and molecular differences of breast cancer across genetic ancestries. It unravels critical insights that challenge the status quo of one-size-fits-all approaches in cancer screening and treatment. By embracing genetic diversity and fostering equitable research inclusion, the medical community can move closer to achieving truly personalized and effective breast cancer care for all women, regardless of their genetic heritage. The study is a clarion call to action—to dismantle the barriers of inequity and to harness science as a force for universal health advancement.
Subject of Research: People
Article Title: The clinical and molecular landscape of breast cancer in women of African and South Asian ancestry
News Publication Date: 20-May-2025
Web References:
http://dx.doi.org/10.1038/s41467-025-59144-z
References:
Chelala, C., et al. (2025). The clinical and molecular landscape of breast cancer in women of African and South Asian ancestry. Nature Communications. https://doi.org/10.1038/s41467-025-59144-z
Keywords:
Breast cancer, Health disparity, Health equity, Personalized medicine
Tags: African South Asian breast cancer outcomesbiological heterogeneity of breast cancerbreast cancer ethnic disparitiesbreast cancer research imbalancesclinical trials diversity in cancer researchgenetic ancestry in breast cancerhealthcare equity in cancer treatmentimplications for cancer prevention strategiesmortality rates in breast cancer populationspersonalized breast cancer careprecision oncology and public healthwomen’s health disparities
