Background: Breast cancer remains the most commonly diagnosed cancer among women worldwide, with significant disparities in outcomes based on socioeconomic status (SES). This comprehensive review examines the complex relationships between socioeconomic factors and breast cancer detection, treatment, and survival outcomes.

Methods: We conducted a systematic analysis of current literature from multiple databases including PubMed, Scopus, and Embase, focusing on studies published between 2000-2025 that investigated socioeconomic determinants of breast cancer outcomes.

Results: Low SES is consistently associated with later stage at diagnosis, reduced access to guideline-concordant care, and worse survival outcomes. Women with lower SES have a 16-37% higher risk of breast cancer-specific mortality compared to those with higher SES. Disparities in mammography screening, Oncotype DX testing (with 41.4% overall testing rate but significantly lower rates in low-SES groups), and treatment adherence mediate these survival differences. Neighborhood-level socioeconomic factors independently influence outcomes beyond individual socioeconomic measures.

Conclusions: Socioeconomic factors significantly impact breast cancer detection and survival through complex, multifactorial pathways. Addressing these disparities requires coordinated interventions at health system, community, and policy levels to improve equitable access to screening, precision diagnostics, and timely treatment