Breast Cancer Equity: Dr. William Audeh on Genomic Tumor Biology

In the United States, Black women are 38% more likely to die from breast cancer than White women, as the American Cancer Society reported in 2024. While socioeconomic factors and healthcare access play a critical role, they do not tell the whole story. Emerging research suggests that a significant portion of this disparity is hidden within the tumor biology itself. Black women are disproportionately affected by aggressive, basal-type cancers that often evade standard clinical markers, leading to potential misclassification and undertreatment.

CURE spoke with Dr. William Audeh, Chief Medical Officer at Agendia, to discuss how genomic subtyping is revolutionizing the approach to health equity. Audeh explored a puzzling trend: even when Black patients are identified with high-risk genomic profiles, they may receive different patterns of care than their White counterparts. By moving beyond traditional hormone receptor status to a comprehensive, unbiased examination of gene activity, clinicians can provide risk-aligned care that ensures every patient receives the treatment their specific biology demands.

Transcript:

Data from the FLEX study suggest that even when Black patients are identified with high-risk genomic profiles, they are sometimes less likely to receive neo/adjuvant chemotherapy than their White counterparts. What systemic or clinical hurdles are preventing these high-risk patients from receiving the "risk-aligned care" research supports?

That is a puzzle as to why there might be a different pattern of delivery of care, particularly neoadjuvant or preoperative therapy, for Black women as opposed to White women. That's something we're really looking into, because the genomic risk that we identify, high risk, means that this is a cancer that needs to be treated with chemotherapy, whether we give it before surgery or after surgery, the results are still the same that the chance of cure for these aggressive cancers is much higher when we apply the appropriate, I would say, personalized therapy.

Why some clinicians are choosing to offer neoadjuvant therapy to some women and not others is something we're really looking into, but there's absolutely no reason why that should be. And I think this is something that will diminish with more education and awareness of the importance of these genomic categories that we're finding.

Reference:

1. “Breast Cancer Incidence Still Rises and Death Rate Still Declines,” American Cancer Society; https://www.cancer.org/research/acs-research-news/breast-cancer-incidence-still-rises-and-death-rate-still-declines.html

Transcript has been edited for clarity and conciseness.

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