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Black women diagnosed with hormone receptor–positive (HR+) breast cancer experience significantly worse outcomes than white women.

With HR+ breast cancer representing the most common type of breast cancer and a leading cause of cancer-related death in women around the world, Svasti Haricharan's lab set out to uncover more about why this gap exists and how it can be closed.

Research has shown that genetics plays a large role in health disparities for a range of diseases and conditions. With this hypothesis in mind, Haricharan and her team searched for a data set to examine the specific race- or ancestry-based molecular biology that may lead to poorer HR+ breast cancer outcomes in Black women.

"Most existing data sets heavily underrepresent anyone who is nonwhite, so we went to the Department of Veterans Affairs, which has the largest archival tissue bank from nonwhite women," Haricharan said.

When her team took a close look at the HR+ breast cancer cells in Black and white women, the results were not what they were expecting.

"What stood out immediately was that we weren't seeing that many differences in what was happening inside the cancer cells, but we were seeing differences in what was happening outside the cells," Haricharan said.

Often, disparities can be explained by differences within the cancer cells, such as genetic mutations that are associated with ancestry. But differences outside the cells, like those the team found, are caused by lifestyle factors.

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