Neighborhood Conditions Drive Worse Breast Cancer Outcomes in Young Women

poor neighborhood © Kristina Blokhin - stock.adobe.com

Living in a disenfranchised neighborhood is more detrimental than race, BMI or breast cancer subtype when it comes to disease progression in women diagnosed with breast cancer before age 40, according to the results of a recent study. Poster details were presented today at the 2024 San Antonio Breast Cancer Symposium by a team of researchers led by Melanie Sheen, M.D., who is a breast cancer oncologist at Ochsner MD Anderson Cancer Center in New Orleans.

Inequities were measured using the Area Deprivation Index (ADI), which is a test that uses census data to measure the concentration of people in a given neighborhood experiencing hardships in education, income, housing and household characteristics such as Wi-Fi access or car ownership. A higher ADI score means there are more discrepancies present.

From 2012 to 2022, Sheen and her team analyzed Ochsner Health System health chart data to identify 719 breast cancer patients under the age of 40 living in Louisiana, which has one of the largest African American populations in the country at 32.8%, compared with 12% of the overall United States population. Louisiana also has a high number of high ADI neighborhoods.

Breast cancer diagnoses for women under the age of 40 accounts for 7% to 9% of all cases and is often more aggressive than cases diagnosed after 40, the abstract reads. It is also becoming more common. African American women are twice as likely than White women to develop triple negative breast cancer, an aggressive subtype. Postmenopausal women with a higher BMI are also more likely to develop breast cancer with one study reporting a 2% increase in breast cancer risk for every 11 pounds gained.

Of the 719 patients analyzed, 689 lived in a high ADI neighborhood. Of the 719, 273 were African American and 446 were White.

A total of 26.7% (African American 47.7%, White 14.3%) of women living in neighborhoods with a high ADI reported disease progression, when compared with 9% (African American 4.3%, White 11.8%) of women living in low ADI neighborhoods.

“While there are differences in disease biology, the impact of ADI on outcomes should not be underestimated,” Sheen and her team write in the abstract. “Improvements in BC awareness, access to care, and support programs should target areas of highest ADI to improve long-term BC outcomes, especially in young populations, regardless of race.”