In 2017, the American Cancer Society estimated 252,710 new invasive breast cancer cases and 40,610 deaths among US women. Breast cancer incidence rates increased among Asian/Pacific Islanders, non-Hispanic blacks, and Hispanics from 2005 to 2014, while rates remained stable among non-Hispanic whites and American Indians/Alaska Natives. Hormone receptor-positive breast cancer rates increased across all racial/ethnic groups, while hormone receptor-negative rates decreased. Breast cancer death rates declined by 39% from 1989 to 2015, preventing 322,600 deaths. However, non-Hispanic black women continued to have higher death rates than non-Hispanic white women, with a 39% higher mortality rate ratio in 2015. State-level disparities were significant, with Louisiana having the highest excess death rate (66%) and Nevada the lowest (20%). In seven states, death rates between black and white women were not statistically different, possibly due to small sample sizes. Racial disparities in breast cancer mortality are influenced by biological, nonbiological, and social factors, including access to care, treatment adherence, and tumor characteristics. Triple-negative breast cancer is more common in non-Hispanic black women and is associated with poorer survival. Geographic variations in breast cancer incidence, mortality, and mammography use were significant, with some states showing lower death rates and higher proportions of in situ diagnoses among non-Hispanic black women. Improving access to care can help eliminate racial disparities in breast cancer mortality. The study highlights the need for targeted interventions to address health disparities and improve outcomes for all populations.In 2017, the American Cancer Society estimated 252,710 new invasive breast cancer cases and 40,610 deaths among US women. Breast cancer incidence rates increased among Asian/Pacific Islanders, non-Hispanic blacks, and Hispanics from 2005 to 2014, while rates remained stable among non-Hispanic whites and American Indians/Alaska Natives. Hormone receptor-positive breast cancer rates increased across all racial/ethnic groups, while hormone receptor-negative rates decreased. Breast cancer death rates declined by 39% from 1989 to 2015, preventing 322,600 deaths. However, non-Hispanic black women continued to have higher death rates than non-Hispanic white women, with a 39% higher mortality rate ratio in 2015. State-level disparities were significant, with Louisiana having the highest excess death rate (66%) and Nevada the lowest (20%). In seven states, death rates between black and white women were not statistically different, possibly due to small sample sizes. Racial disparities in breast cancer mortality are influenced by biological, nonbiological, and social factors, including access to care, treatment adherence, and tumor characteristics. Triple-negative breast cancer is more common in non-Hispanic black women and is associated with poorer survival. Geographic variations in breast cancer incidence, mortality, and mammography use were significant, with some states showing lower death rates and higher proportions of in situ diagnoses among non-Hispanic black women. Improving access to care can help eliminate racial disparities in breast cancer mortality. The study highlights the need for targeted interventions to address health disparities and improve outcomes for all populations.