Living in a disadvantaged NYC neighborhood is associated with poorly differentiated breast cancer and shorter breast cancer-specific survival Journal Article

  

Authors:	Miller, C. P.; Le, T.; Amburn, T.; Sevilimedu, V.; Tadros, A. B.; Downs-Canner, S.; Plitas, G.; Barrio, A.; Morrow, M.; Goel, N.
Article Title:	Living in a disadvantaged NYC neighborhood is associated with poorly differentiated breast cancer and shorter breast cancer-specific survival
Abstract:	Objective: To evaluate the association between living in disadvantaged neighborhoods in New York City (NYC) with tumor grade, a clinical proxy for proliferation and tumor aggressiveness, and breast cancer-specific survival (BCSS). Summary Background Data: Neighborhood disadvantage (ND) is associated with shorter BCSS, independent of individual-level, tumor, and treatment characteristics, highlighting unmeasured factors associated with this survival disparity. Methods: Women with stage I-III BCa living in NYC treated at Memorial Sloan Kettering Cancer Center from 2013-2024 were included. ND was stratified using the Area Deprivation Index (ADI). The median ADI for the cohort was 3 and was used as the cutoff between neighborhood advantage (NA, ADI 1-3) and ND (ADI 4-10). Multivariable logistic regression and cox proportional hazards modeling, controlling for individual, tumor, and treatment factors, were used to determine the association between ND and tumor grade and BCSS, respectively. Results: 5452 women with BCa were included. 3479 (64%) lived in NA and 1973 (36%) in ND. On multivariable analysis, ND had higher odds of poorly vs. well/moderately differentiated tumors (aOR 1.23, CI 1.03-1.48), independent of age, race/ethnicity, insurance, BMI, smoking/alcohol, stage, and subtype. ND was also associated with shorter BCSS (aHR 1.56, CI 1.05-2.38). Conclusions: Women living in ND in NYC were more likely to present with poorly differentiated tumors and have shorter BCSS. These findings merit further inquiry and lay the foundation for future translational studies to externally validate the mechanisms by which ND "gets under the skin"to impact aggressive BCa tumor biology, and ultimately survival. Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.
Keywords:	breast cancer specific survival; neighborhood disadvantage; poorly differentiated tumors; translational epidemiological framework; york city
Journal Title:	Annals of Surgery
ISSN:	0003-4932
Publisher:	Lippincott Williams & Wilkins
Publication status:	Online ahead of print
Date Published:	2025-07-04
Online Publication Date:	2025-07-04
Language:	English
DOI:	10.1097/sla.0000000000006828
PROVIDER:	scopus
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-105010875013&doi=10.1097%2fSLA.0000000000006828&partnerID=40&md5=0c50ca36633f9ba21b7def8499d779a2
Notes:	The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Corresponding authors is MSK author: Neha Goel -- Source: Scopus

https://synapse.mskcc.org/synapse/works/has_related_data_chk/227404