<p>Breast cancer mortality rates have declined steadily over the past 40 years, as enhanced screening has shifted the balance of new diagnoses to curable, early-stage cancers while advances in systemic therapy have yielded improved and increasingly durable outcomes even for locally advanced and metastatic disease. However, this reduction in mortality has not been equitably distributed among all racial groups, and there continue to be significant racial and ethnic disparities. In this review, we summarize research that has contributed to our understanding of disparities in breast surgical oncology across all racial/ethnic groups, however, given that the most egregious disparities exist among Black women, our review will involve considerable focus on this racial group. We will discuss racial disparities across the breast cancer continuum including access to care, diagnosis, surgical treatment, and survivorship and will conclude with strategies to redress them.</p>