Purpose of Review <p>Breast cancer is the second leading cause of cancer-related death among American women. Although mammography improves early detection and survival, numerous barriers limit routine screening. These arise at multiple levels—from distal factors such as limited infrastructure and access to imaging centers, to intermediate factors including neighborhood disadvantage and cultural or social beliefs, to proximal factors such as socioeconomic status, and low health literacy stigma. Vulnerable groups, including women with disabilities, LGBTQ+ individuals, and older adults, often face layered challenges. This review examines distal, intermediate, and proximal factors contributing to breast cancer screening barriers.</p> Recent Findings <p>Recent studies highlight persistent inequities in breast cancer screening access and utilization, particularly among marginalized populations. Evidence shows that these barriers operate at multiple levels—distal, intermediate, and proximal—compounding disparities in screening.</p> Summary <p>Reducing breast cancer screening disparities requires multilevel, context-specific interventions that expand access, strengthen education, and promote culturally competent care to improve early detection and outcomes across diverse populations.</p>