Breast cancer in immigrant women in Europe and Italy: epidemiology, disparities, and pathways to equity.

Immigrant women in Europe and Italy represent a growing and heterogeneous population whose breast cancer (BC) experience is influenced by social, cultural, and healthcare system factors. Although first-generation immigrants generally have a lower BC incidence, risk converges over time with that of native populations, while barriers to care persist. To analyze disparities in BC screening, diagnosis, tumour characteristics, treatment pathways, and outcomes among immigrant women in Europe and Italy, and to identify strategies to promote equity. A narrative review of European and Italian literature was conducted, focusing on screening uptake, stage at diagnosis, tumour biology, access to diagnostics and treatments, and outcomes. Social determinants of health and healthcare system barriers were also considered. Screening participation is consistently lower among immigrant women because of a combination of language barriers, limited knowledge of screening programmes, limited culturally shaped beliefs, about health and cancer, competing work and caregiving responsibilities, and practical obstacles such as transportation and appointment scheduling, leading to delayed diagnosis and more advanced disease. Socioeconomic disadvantage and residence in underserved areas further limit access to diagnostic procedures, treatment, and follow-up. Potential differences in tumour biology have been reported, but data are limited and rarely stratified by region of origin. Disparities also affect treatment pathways, with delays and unequal access to advanced technologies. Long-term outcomes remain poorly documented. Reducing disparities requires coordinated policy and health system interventions, including standardized migration data collection, equitable access to screening and treatment, inclusion in clinical research, and culturally tailored education and patient-navigation programs. Equity should be central to BC care in Europe and Italy.