Breast cancer affects over three million women in the United States, but this disease burden is not shared equally across all races. Black women, in particular, are diagnosed with more advanced cancer at a younger age and experience a disproportionately high mortality rate compared to white women. Factors that contribute to such disparity include socioeconomic status, tumor biology, age, insurance status, comorbidities, obesity, patients’ reproductive history and barriers to quality care. These factors alone, however, do not account for all the racial differences in mortality and outcomes experienced by black women. There is a growing body of literature that indicates black women are not receiving the same treatment and care as white women. Black women are less likely to receive surgery, radiation therapy, hormone therapy and targeted therapy than white women. Black women are also more likely to experience delays in the initiation of treatment, early discontinuation of treatment and overall guideline non-concordant care. The current literature has presented widespread racial disparities in the treatment of black women with breast cancer. Future research needs to focus on tangible interventions such as physician bias training and patient navigators to mitigate the inequity of care in the treatment of breast cancer.

The introduction of an increasing number of individualized molecular targeted therapies into clinical routine mirrors their importance in modern cancer prevention and treatment. Well-known examples for targeted agents are the monoclonal antibody trastuzumab and the selective estrogen receptor modulator tamoxifen. The identification of an unaltered gene in tumor tissue in colon cancer (KRAS) is a predictor for the patient’s response to targeted therapy with a monoclonal antibody (cetuximab). Targeted therapy for hereditary breast and ovarian cancer has become a reality with the approval of olaparib for platin-sensitive late relapsed BRCA-associated ovarian cancer in December 2014. This manuscript reviews the status quo of poly-ADP-ribose polymerase inhibitors (PARPi) in the therapy of breast and ovarian cancer as well as the struggle for carboplatin as a potential standard of care for triple-negative and, in particular, BRCA-associated breast cancer. Details of the mechanism of action with information on tumor development are provided, and an outlook for further relevant research is given. The efficacy of agents against molecular targets together with the identification of an increasing number of cancer-associated genes will open the floodgates to a new era of treatment decision-making based on molecular tumor profiles. Current clinical trials involving patients with BRCA-associated cancer explore the efficacy of the molecular targeted therapeutics platinum and PARPi.