Targeting racial disparities in breast cancer: mechanistic insights and therapeutic potential of African medicinal plants

Abstract

This review examines the multifaceted disparities in breast cancer outcomes between African American and European American women, with a focus on molecular drivers, epigenetic determinants, and the therapeutic potential of African medicinal plants. It addresses three key questions: (1) What biological mechanisms underlie racial disparities in breast cancer aggressiveness and survival? (2) How do gene-environment interactions contribute to these disparities? (3) Can African medicinal plants offer targeted solutions for high-risk populations?. A non-systematic literature search was conducted across PubMed, Web of Science, and Scopus using keywords such as "breast cancer disparities," "African American women," "tumor microenvironment," "DNA methylation," and "African medicinal plants." English-language studies were prioritized, encompassing molecular oncology, epidemiology, and ethnopharmacology. Data were synthesized into thematic areas like biological mechanisms and plant-derived therapies. AA women exhibit distinct tumor biology, including hypermethylation of tumor suppressors (RARB, CDH13), gene mutations (TP53), and pro-inflammatory microenvironments with elevated cytokines (IL-6, CCL5). Social determinants like structural racism and healthcare access barriers exacerbate outcomes. African medicinal plants like Vernonia amygdalina (IC₅₀ 0.87 μg/mL) demonstrate cytotoxicity against triple-negative breast cancer through NF-κB inhibition and apoptosis induction, aligning with disparity-associated pathways. Racial disparities in breast cancer arise from intersecting biological and social factors. Precision approaches, including epigenetic therapies and plant-derived compounds, may help bridge survival gaps. Integrating traditional knowledge with modern oncology could yield equitable interventions for high-risk European and African populations.

Keywords: African American women; African medicinal plants; Breast cancer disparities; DNA methylation; Triple-negative breast cancer; Tumor microenvironment.