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Breast Cancer Research and Treatment

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Open Access 01-04-2020 | Breast Cancer | Epidemiology

Associations between breast cancer subtype and neighborhood socioeconomic and racial composition among Black and White women

Authors: Erin Linnenbringer, Arline T. Geronimus, Kia L. Davis, John Bound, Libby Ellis, Scarlett L. Gomez

Published in: Breast Cancer Research and Treatment | Issue 2/2020

Abstract

Purpose

Studies of Black–White differences in breast cancer subtype often emphasize potential ancestry-associated genetic or lifestyle risk factors without fully considering how the social or economic implications of race in the U.S. may influence risk. We assess whether neighborhood racial composition and/or socioeconomic status are associated with odds of triple-negative breast cancer (TNBC) diagnosis relative to the less-aggressive hormone receptor-positive/HER2-negative subtype (HR+ /HER−), and whether the observed relationships vary across women’s race and age groups.

Methods

We use multilevel generalized estimating equation models to evaluate odds of TNBC vs. HR+ /HER2− subtypes in a population-based cohort of 7291 Black and 74,208 White women diagnosed with breast cancer from 2006 to 2014. Final models include both neighborhood-level variables, adjusting for individual demographics and tumor characteristics.

Results

Relative to the HR+ /HER− subtype, we found modestly lower odds of TNBC subtype among White women with higher neighborhood median household income (statistically significant within the 45–64 age group, OR = 0.981 per $10,000 increase). Among Black women, both higher neighborhood income and higher percentages of Black neighborhood residents were associated with lower odds of TNBC relative to HR+ /HER2−. The largest reduction was observed among Black women diagnosed at age ≥ 65 (OR = 0.938 per $10,000 increase; OR = 0.942 per 10% increase in Black residents).

Conclusion

The relationships between neighborhood composition, neighborhood socioeconomic status, and odds of TNBC differ by race and age. Racially patterned social factors warrant further exploration in breast cancer subtype disparities research.

Hirschman J, Whitman S, Ansell D (2007) The black:white disparity in breast cancer mortality: the example of Chicago. Cancer Causes Control 18(3):323–333CrossRefPubMed

Gorin SS, Heck JE, Cheng B, Smith SJ (2006) Delays in breast cancer diagnosis and treatment by racial/ethnic group. Arch Intern Med 166(20):2244–2252CrossRefPubMed

Bradley C, Given C, Roberts C (2002) Race, socioeconomic status, and breast cancer treatment and survival. J Natl Cancer Inst 94(7):490–496CrossRefPubMed

Kohler BA, Sherman RL, Howlader N, Jemal A, Ryerson AB, Henry KA, Boscoe FP, Cronin KA, Lake A, Noone A-M, Henley SJ, Eheman CR, Anderson RN, Penberthy L (2015) Annual report to the nation on the status of cancer, 1975-2011, featuring incidence of breast cancer subtypes by race/ethnicity, poverty, and state. J Natl Cancer Inst. https://doi.org/10.1093/jnci/djv048 CrossRefPubMedPubMedCentral

Amend K, Hicks D, Ambrosone CB (2006) Breast cancer in African-American women: differences in tumor biology from European-American women. Cancer Res 66(17):8327–8330CrossRefPubMed

DeSantis C, Jemal A, Ward E (2010) Disparities in breast cancer prognostic factors by race, insurance status, and education. Cancer Causes Control 21(9):1445–1450CrossRefPubMed

Sorlie T, Tibshirani R, Parker J, Hastie T, Marron JS, Nobel A, Deng S, Johnsen H, Pesich R, Geisler S, Demeter J, Perou CM, Lonning PE, Brown PO, Borresen-Dale AL, Botstein D (2003) Repeated observation of breast tumor subtypes in independent gene expression data sets. Proc Natl Acad Sci USA 100(14):8418–8423CrossRefPubMedPubMedCentral

Dietze EC, Sistrunk C, Miranda-Carboni G, O'Regan R, Seewaldt VL (2015) Triple-negative breast cancer in African-American women: disparities versus biology. Nat Rev Cancer 15(4):248–254. https://doi.org/10.1038/nrc3896 CrossRefPubMedPubMedCentral

Newman LA, Kaljee LM (2017) Health disparities and triple-negative breast cancer in african american women: a review. JAMA Surg. https://doi.org/10.1001/jamasurg.2017.0005 CrossRefPubMedPubMedCentral

10.

Scott LC, Mobley LR, Kuo T-M, Il’yasova D (2019) Update on triple-negative breast cancer disparities for the United States: A population-based study from the United States Cancer Statistics database, 2010 through 2014. Cancer. https://doi.org/10.1002/cncr.32207 CrossRefPubMedPubMedCentral

11.

Elias AD (2010) Triple-negative breast cancer: a short review. Am J Clin Oncol 33(6):637–645. https://doi.org/10.1097/COC.0b013e3181b8afcf CrossRefPubMed

12.

Dent R, Trudeau M, Pritchard KI, Hanna WM, Kahn HK, Sawka CA, Lickley LA, Rawlinson E, Sun P, Narod SA (2007) Triple-negative breast cancer: clinical features and patterns of recurrence. Clin Cancer Res 13(15 Pt 1):4429–4434. https://doi.org/10.1158/1078-0432.Ccr-06-3045 CrossRefPubMed

13.

Sharma P (2016) Biology and management of patients with triple-negative breast cancer. Oncologist 21(9):1050–1062. https://doi.org/10.1634/theoncologist.2016-0067 CrossRefPubMedPubMedCentral

14.

Li X, Yang J, Peng L, Sahin AA, Huo L, Ward KC, O'Regan R, Torres MA, Meisel JL (2017) Triple-negative breast cancer has worse overall survival and cause-specific survival than non-triple-negative breast cancer. Breast Cancer Res Treat 161(2):279–287. https://doi.org/10.1007/s10549-016-4059-6 CrossRefPubMed

15.

Howlader N, Cronin KA, Kurian AW, Andridge R (2018) Differences in breast cancer survival by molecular subtypes in the United States. Cancer Epidemiol Biomark Prev 26(7):619–626. https://doi.org/10.1158/1055-9965.EPI-17-0627 CrossRef

16.

Gordon NH (1995) Association of education and income with estrogen receptor status in primary breast cancer. Am J Epidemiol 142(8):796–803CrossRefPubMed

17.

Vona-Davis L, Rose DP (2009) The influence of socioeconomic disparities on breast cancer tumor biology and prognosis: a review. J Women's Health 18(6):883–893. https://doi.org/10.1089/jwh.2008.1127 CrossRef

18.

Williams DR, Mohammed SA, Shields AE (2016) Understanding and effectively addressing breast cancer in African American women: unpacking the social context. Cancer. https://doi.org/10.1002/cncr.29935 CrossRefPubMedPubMedCentral

19.

Andaya AA, Enewold L, Horner MJ, Jatoi I, Shriver CD, Zhu K (2012) Socioeconomic disparities and breast cancer hormone receptor status. Cancer Causes Control 23(6):951–958. https://doi.org/10.1007/s10552-012-9966-1 CrossRefPubMed

20.

Williams DR, Collins C (2001) Racial residential segregation: a fundamental cause of racial disparities in health. Public Health Rep 116(5):404–416CrossRefPubMedPubMedCentral

21.

Haas JS, Earle CC, Orav JE, Brawarsky P, Keohane M, Neville BA, Williams DR (2008) Racial segregation and disparities in breast cancer care and mortality. Cancer 113(8):2166–2172. https://doi.org/10.1002/cncr.23828 CrossRefPubMed

22.

Pruitt SL, Lee SJC, Tiro JA, Xuan L, Ruiz JM, Inrig S (2015) Residential racial segregation and mortality among Black, White, and Hispanic urban breast cancer patients in Texas, 1995 to 2009. Cancer 121(11):1845–1855. https://doi.org/10.1002/cncr.29282 CrossRefPubMed

23.

Russell EF, Kramer MR, Cooper HL, Gabram-Mendola S, Senior-Crosby D, Jacob Arriola KR (2012) Metropolitan area racial residential segregation, neighborhood racial composition, and breast cancer mortality. Cancer Causes Control 23(9):1519–1527. https://doi.org/10.1007/s10552-012-0029-4 CrossRefPubMed

24.

Hinzey A, Gaudier-Diaz MM, Lustberg MB, DeVries AC (2016) Breast cancer and social environment: getting by with a little help from our friends. Breast Cancer Res 18(1):54. https://doi.org/10.1186/s13058-016-0700-x CrossRefPubMedPubMedCentral

25.

Linnenbringer E, Gehlert S, Geronimus AT (2017) Black-White disparities in breast cancer subtype: the intersection of socially patterned stress and genetic expression. AIMS Public Health 4(5):526–556. https://doi.org/10.3934/publichealth.2017.5.526 CrossRefPubMedPubMedCentral

26.

Bemanian A, Beyer KMM (2017) Measures matter: the local exposure/isolation (LEx/Is) metrics and relationships between local-level segregation and breast cancer survival. Cancer Epidemiol Biomark Prev 26(4):516–524. https://doi.org/10.1158/1055-9965.epi-16-0926 CrossRef

27.

Beyer KMM, Zhou Y, Matthews K, Bemanian A, Laud PW, Nattinger AB (2016) New spatially continuous indices of redlining and racial bias in mortgage lending: links to survival after breast cancer diagnosis and implications for health disparities research. Health Place 40:34–43. https://doi.org/10.1016/j.healthplace.2016.04.014 CrossRefPubMed

28.

Warner E, Gomez S (2010) Impact of neighborhood racial composition and metropolitan residential segregation on disparities in breast cancer stage at diagnosis and survival between black and white women in California. J Community Health 35(4):398–408CrossRefPubMedPubMedCentral

29.

Geronimus AT (1992) The weathering hypothesis and the health of African-American women and infants: evidence and speculations. Ethn Dis 2(3):207–221PubMed

30.

Geronimus AT, Hicken M, Keene D, Bound J (2006) "Weathering" and age patterns of allostatic load scores among blacks and whites in the United States. Am J Public Health 96(5):826–833. https://doi.org/10.2105/AJPH.2004.060749 CrossRefPubMedPubMedCentral

31.

Krieger N (2012) Methods for the scientific study of discrimination and health: an ecosocial approach. Am J Public Health 102(5):936–944CrossRefPubMedPubMedCentral

32.

Geronimus AT, Pearson JA, Linnenbringer E, Schulz AJ, Reyes AG, Epel ES, Lin J, Blackburn EH (2015) Race-ethnicity, poverty, urban stressors, and telomere length in a detroit community-based sample. J Health Soc Behav. https://doi.org/10.1177/0022146515582100 CrossRefPubMedPubMedCentral

33.

Hunt MO, Wise LR, Jipguep MC, Cozier YC, Rosenberg L (2007) Neighborhood racial composition and perceptions of racial discrimination: evidence from the black women's health study. Soc Psychol Q 70(3):272–289CrossRef

34.

Taylor TR, Williams CD, Makambi KH, Mouton C, Harrell JP, Cozier Y, Palmer JR, Rosenberg L, Adams-Campbell LL (2007) Racial discrimination and breast cancer incidence in US black women—the Black Women's Health Study. Am J Epidemiol 166(1):46–54CrossRefPubMed

35.

Gomez S, Glaser S, McClure L, Shema S, Kealey M, Keegan T, Satariano W (2011) The California Neighborhoods Data System: a new resource for examining the impact of neighborhood characteristics on cancer incidence and outcomes in populations. Cancer Causes Control 22(4):631–647CrossRefPubMedPubMedCentral

36.

Hammond MEH, Hayes DF, Dowsett M, Allred DC, Hagerty KL, Badve S, Fitzgibbons PL, Francis G, Goldstein NS, Hayes M, Hicks DG, Lester S, Love R, Mangu PB, McShane L, Miller K, Osborne CK, Paik S, Perlmutter J, Rhodes A, Sasano H, Schwartz JN, Sweep FCG, Taube S, Torlakovic EE, Valenstein P, Viale G, Visscher D, Wheeler T, Williams RB, Wittliff JL, Wolff AC (2010) American Society of Clinical Oncology/College Of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer. J Clin Oncol 28(16):2784–2795. https://doi.org/10.1200/JCO.2009.25.6529 CrossRefPubMedPubMedCentral

37.

Clegg LX, Reichman ME, Hankey BF, Miller BA, Lin YD, Johnson NJ, Schwartz SM, Bernstein L, Chen VW, Goodman MT, Gomez SL, Graff JJ, Lynch CF, Lin CC, Edwards BK (2007) Quality of race, Hispanic ethnicity, and immigrant status in population-based cancer registry data: implications for health disparity studies. Cancer Causes Control 18(2):177–187. https://doi.org/10.1007/s10552-006-0089-4 CrossRefPubMed

38.

Gomez SL, Glaser SL (2006) Misclassification of race/ethnicity in a population-based cancer registry (United States). Cancer Causes Control 17(6):771–781. https://doi.org/10.1007/s10552-006-0013-y CrossRefPubMed

39.

Gold EB (2011) The timing of the age at which natural menopause occurs. Obstet Gynecol Clin N Am 38(3):425–440. https://doi.org/10.1016/j.ogc.2011.05.002 CrossRef

40.

Hill K (1996) The demography of menopause. Maturitas 23(2):113–127CrossRefPubMed

41.

Geronimus AT, Bound J (1998) Use of census-based aggregate variables to proxy for socioeconomic group: evidence from national samples. Am J Epidemiol 148(5):475–486CrossRefPubMed

42.

Hubbard AE, Ahern J, Fleischer NL, Van der Laan M, Lippman SA, Jewell N, Bruckner T, Satariano WA (2010) To GEE or not to GEE: comparing population average and mixed models for estimating the associations between neighborhood risk factors and health. Epidemiology (Cambridge, Mass) 21(4):467–474. https://doi.org/10.1097/EDE.0b013e3181caeb90 CrossRef

43.

Hosmer DW, Lemeshow S, Sturdivant RX (2013) Applied logistic regression. Third Edition edn. Wiley, Hoboken, NJCrossRef

44.

Akinyemiju TF, Pisu M, Waterbor JW, Altekruse SF (2015) Socioeconomic status and incidence of breast cancer by hormone receptor subtype. SpringerPlus 4(1):1–8. https://doi.org/10.1186/s40064-015-1282-2 CrossRef

45.

Palmer JR, Boggs DA, Wise LA, Adams-Campbell LL, Rosenberg L (2012) Individual and neighborhood socioeconomic status in relation to breast cancer incidence in African-American women. Am J Epidemiol 176(12):1141–1146. https://doi.org/10.1093/aje/kws211 CrossRefPubMedPubMedCentral

46.

Krieger N, Singh N, Waterman PD (2016) Metrics for monitoring cancer inequities: residential segregation, the Index of Concentration at the Extremes (ICE), and breast cancer estrogen receptor status (USA, 1992–2012). Cancer Causes Control 27(9):1139–1151. https://doi.org/10.1007/s10552-016-0793-7 CrossRefPubMed

47.

Kramer MR, Hogue CR (2009) Is Segregation Bad for Your Health? Epidemiol Rev 31(1):178–194. https://doi.org/10.1093/epirev/mxp001 CrossRefPubMed

48.

Welch S, Sigelman L, Bledsoe T, Combs M (2001) Race and place: race relations in an American city. Cambridge studies in political psychology and public opinion vol xvi, 206 p. Cambridge University Press, Cambridge, U.K.

49.

James SA (1993) Racial and ethnic differences in infant mortality and low birth weight. A psychosocial critique. Ann Epidemiol 3(2):130–136CrossRefPubMed

50.

Das-Munshi J, Becares L, Dewey ME, Stansfeld SA, Prince MJ (2010) Understanding the effect of ethnic density on mental health: multi-level investigation of survey data from England. Br Med J 341:c5367. https://doi.org/10.1136/bmj.c5367 CrossRef

51.

Keene DE, Geronimus AT (2011) Community-based support among African American public housing residents. J Urban Health: Bull N Y Acad Med 88(1):41–53. https://doi.org/10.1007/s11524-010-9511-z CrossRef

52.

Krieger N, Jahn JL, Waterman PD (2017) Jim Crow and estrogen-receptor-negative breast cancer: US-born black and white non-Hispanic women, 1992–2012. Cancer Causes Control 28(1):49–59. https://doi.org/10.1007/s10552-016-0834-2 CrossRefPubMed

53.

Krieger N, Chen JT, Ware JH, Kaddour A (2008) Race/ethnicity and breast cancer estrogen receptor status: impact of class, missing data, and modeling assumptions. Cancer Causes Control 19(10):1305–1318. https://doi.org/10.1007/s10552-008-9202-1 CrossRefPubMedPubMedCentral

54.

Groenwold RHH, Donders ART, Roes KCB, Harrell JFE, Moons KGM (2012) Dealing with missing outcome data in randomized trials and observational studies. Am J Epidemiol 175(3):210–217. https://doi.org/10.1093/aje/kwr302 CrossRefPubMed

55.

Palmer JR, Viscidi E, Troester MA, Hong C-C, Schedin P, Bethea TN, Bandera EV, Borges V, McKinnon C, Haiman CA, Lunetta K, Kolonel LN, Rosenberg L, Olshan AF, Ambrosone CB (2014) Parity, lactation, and breast cancer subtypes in African American women: results from the AMBER Consortium. J Natl Cancer Inst. https://doi.org/10.1093/jnci/dju237 CrossRefPubMedPubMedCentral

Title: Associations between breast cancer subtype and neighborhood socioeconomic and racial composition among Black and White women
Authors: Erin Linnenbringer
Arline T. Geronimus
Kia L. Davis
John Bound
Libby Ellis
Scarlett L. Gomez
Publication date: 01-04-2020
Publisher: Springer US
Keywords: Breast Cancer
Breast Cancer
Published in: Breast Cancer Research and Treatment / Issue 2/2020
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-020-05545-1

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