Background: We examined epidemiological trends and patient characteristics including age, race, incidence and survival in female breast cancer (BC) using the updated largest population-based cancer registry in the US. Methods: Female patients diagnosed with breast cancer between 2010-2020 were identified in SEER registries. We incorporated SEER 22 registries to calculate incidence, race, disease characteristics and overall survival. Results: Incidence Rate (IR) for BC has been increasing by 0.4%/year and mortality rates (MR) have declined 1.3%/year during 2010-2020 for all patients. 5-&10-year overall survival (OS) has increased by 0.1 and 0.2% respectively. For ages < 50 years,IR increased by 0.9% vs 0.4% for those 65 and above. No statistically significant change in IR was noted for ages 50-64y. For ages < 50 and between 50-64y, MR overall decreased by 1.4%/y each vs by 1.1%/y for those 65+. However, no statistically significant change in MR was noted for women < 50y between 2016-2020. IR increased by 1.6%/year in Asian/Pacific Islanders (API), 1.1%/y in Hispanics (H),0.6% in Blacks (B) and 0.4% in Non-Hispanic White (NHW) and. MR declined 1.5%/y in B, 1.2%/y NHW, 1% H and by 0.3% in API.IR for HR+/HER2- BC increased by 1.9%. No statistically significant change in IR was noted for triple negative or HER2+ only BC. IR for HR+/HER2+ BC increased overall during this time period by 1.4%; however, IR increased by 3.6% between 2010-2016 and decreased by 2.9% after 2016. 5y-OS was 91% in 2015 (CI 90.7-91.3) for all women, improved from 89.7% in 2010 (CI 89.4-90.0). 5yOS was 90.7% vs 91.3% vs 91.0% for < 50, 50-64 and 65+ age groups. When compared to 2010 and 2005, 5yOS was consistently improved across all age groups. 5yOS in B was 82.5% (CI 81.6-83.4) vs 92.1% (CI 91.8-92.5) in NHW. This discrepancy existed across all age groups: for < 50, 50-64 and 65+y, 91.6 vs 92.5 vs 92.1% for W women vs 82.7 vs 82.9 vs 82.0% for their B counterparts. 5yOS for localized, regional and distant disease at diagnosis for all women was 99.2%, 86.7% and 31.5%. 5yOS for B vs W females was 95.9 vs 99.7% localized, 78.3 vs 88% regional and 23.4 vs 33.0% for distant disease. Conclusions: Epidemiological trends show improved OS in BC among all groups. B females and patients with advanced stage have worse outcomes. Greater increase in IR was noted for women < 50 years of age. Greater IR increase was noted in H and API women but decline in MR was smallest in these women. IR for HR/HER2 + BC increased initially followed by a decline. 5r survival in B women was lower compared to NHW across all age groups. 5y survival for B women was worse, irrespective of stage at diagnosis. We hypothesize underlying disease biology may be a potential factor for worse outcome in B women.