{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T14:27:13Z","timestamp":1788532033818,"version":"build-2803163510"},"reference-count":25,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: South Asian Americans (SAAs) represent the fastest-growing U.S. immigrant group but remain underrepresented in breast cancer research. This study utilizes the National Cancer Database (NCDB) to evaluate differences in tumor characteristics, treatment patterns, and survival outcomes between SAAs and non-Hispanic Whites (NHWs). Materials and Methods: A retrospective cohort analysis was conducted using NCDB data from 2004\u20132021. Women with breast cancer were stratified by race\/ethnicity (SAA vs. NHW), and demographic, clinical, and treatment variables were compared. Outcomes assessed were overall survival (OS) and treatment delays, defined as initiation of surgery, chemotherapy, or radiation therapy &gt; 60 days after diagnosis. Multivariable Cox proportional hazards models assessed OS. Results: Among 2,363,627 patients, 20,561 (0.9%) were SAAs and 2,343,066 (99.1%) NHWs. SAAs were younger at diagnosis, with 37.6% aged 20\u201349 vs. 20.6% of NHWs (p &lt; 0.001). Insurance coverage differed, with SAAs more likely privately insured (63.0% vs. 54.2%, p &lt; 0.001), less likely on Medicare (17.2% vs. 37.9%), and more often uninsured (4.5% vs. 1.2%). Time to first treatment was longer for SAAs (39.55 vs. 37.17 days, p &lt; 0.001). Surgical delays &gt;60 days increased mortality by 59%, while chemotherapy delays raised it by 44%. SAAs demonstrated higher survival at 5, 10, and 15 years (93%, 87%, 81%) vs. NHWs (87%, 76%, 64%). Median survival was 225.8 months but not estimable for SAAs. SAAs presented with aggressive subtypes: triple-negative and HER2-positive tumors. Conclusions: SAAs present younger with aggressive subtypes and treatment delays yet maintain survival advantages; reducing care barriers and clarifying tumor biology are vital to improving outcomes.<\/jats:p>","DOI":"10.3390\/cancers18172866","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T13:50:44Z","timestamp":1788529844000},"page":"2866","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Disparities in Breast Cancer Diagnosis, Treatment, and Outcomes Among South Asian American Women"],"prefix":"10.3390","volume":"18","author":[{"given":"Jasmin","family":"Hundal","sequence":"first","affiliation":[{"name":"Department of Hematology and Medical Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"given":"Ishan","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"given":"Ashiya","family":"Loomba","sequence":"additional","affiliation":[{"name":"Department of Medicine, Maharaja Agrasen Medical College, Hisar 125047, India"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7959-5040","authenticated-orcid":false,"given":"Yanwen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Quantitative Health Science, Cleveland Clinic, Cleveland, OH 44195, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"}]},{"given":"Halle","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Sudipto","family":"Mukherjee","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"conceptualization","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6657-8647","authenticated-orcid":false,"given":"Abhay","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"ref_1","first-page":"229","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. 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