This letter highlights disparities in breast cancer screening access for refugee women, asylum seekers, and underserved populations in Italy and low-income countries. Systemic barriers (legal, cultural, and infrastructural) contribute to late-stage diagnoses and higher mortality. We propose context-adapted strategies, including mobile ultrasound with AI/teleradiology for low-resource settings and culturally sensitive pathways for marginalized groups in high-income nations. The letter underscores the need for equitable, trauma-informed approaches to breast imaging.