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01-12-2022 | Obesity | Research

Racial disparities in triple negative breast cancer: toward a causal architecture approach

Authors: Scott D. Siegel, Madeline M. Brooks, Shannon M. Lynch, Jennifer Sims-Mourtada, Zachary T. Schug, Frank C. Curriero

Published in: Breast Cancer Research | Issue 1/2022

Abstract

Background

Triple negative breast cancer (TNBC) is an aggressive subtype of invasive breast cancer that disproportionately affects Black women and contributes to racial disparities in breast cancer mortality. Prior research has suggested that neighborhood effects may contribute to this disparity beyond individual risk factors.

Methods

The sample included a cohort of 3316 breast cancer cases diagnosed between 2012 and 2020 in New Castle County, Delaware, a geographic region of the US with elevated rates of TNBC. Multilevel methods and geospatial mapping evaluated whether the race, income, and race/income versions of the neighborhood Index of Concentration at the Extremes (ICE) metric could efficiently identify census tracts (CT) with higher odds of TNBC relative to other forms of invasive breast cancer. Odds ratios (OR) and 95% confidence intervals (CI) were reported; p-values < 0.05 were significant. Additional analyses examined area-level differences in exposure to metabolic risk factors, including unhealthy alcohol use and obesity.

Results

The ICE-Race, -Income-, and Race/Income metrics were each associated with greater census tract odds of TNBC on a bivariate basis. However, only ICE-Race was significantly associated with higher odds of TNBC after adjustment for patient-level age and race (most disadvantaged CT: OR = 2.09; 95% CI 1.40–3.13), providing support for neighborhood effects. Higher counts of alcohol and fast-food retailers, and correspondingly higher rates of unhealthy alcohol use and obesity, were observed in CTs that were classified into the most disadvantaged ICE-Race quintile and had the highest odds of TNBC.

Conclusion

The use of ICE can facilitate the monitoring of cancer inequities and advance the study of racial disparities in breast cancer.

Available only for authorised users

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Title: Racial disparities in triple negative breast cancer: toward a causal architecture approach
Authors: Scott D. Siegel
Madeline M. Brooks
Shannon M. Lynch
Jennifer Sims-Mourtada
Zachary T. Schug
Frank C. Curriero
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Obesity
Obesity
Breast Cancer
Breast Cancer
Published in: Breast Cancer Research / Issue 1/2022
Electronic ISSN: 1465-542X
DOI: https://doi.org/10.1186/s13058-022-01533-z

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Abstract

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