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Background <p>Several studies have shown that residing in regions with high area deprivation index (ADI) is associated with worse outcomes. We evaluated associations between ADI and breast cancer (BC) outcomes among patients in Western New York (WNY), a region that includes multiple underserved areas.</p> Methods <p>This retrospective, single-institution study analyzed data from 404 BC patients diagnosed between 2014 and 2018. Demographic and clinicopathological data were abstracted. Data were compared between high (≥ 60) and low (&lt; 60) ADI groups, reflective of high and low levels of socioeconomic disadvantage, respectively. The primary objective was overall survival (OS) by ADI. Secondary objectives included assessment of recurrence free survival (RFS) or time to next treatment (TNT) by ADI and frequency of germline and somatic testing.</p> Results <p>Over half of the patients (59%) resided in ADI ≥ 60. 77% of patients had stage I-III BC and 23% had de novo metastatic BC. Patients in ADI ≥ 60 had a lower 5-year OS rate (73%) than those in ADI &lt; 60 (84%) (95%CI: 67.5–79.7, <i>P</i> = 0.05). In multivariable analysis, similar trend was observed but was not statistically significant (HR 1.56, 95%CI: 0.98–2.46, <i>P</i> = 0.058). There were no differences in TNT or RFS by ADI. Germline testing was performed less frequently (33%) in ADI ≥ 60 than ADI &lt; 60 group (45%) (<i>P</i> = 0.04) for patients with stage I-III BC, while no difference observed for stage IV patients. Finally, prevalence of somatic mutations in <i>TP53</i>, <i>PIK3CA</i>, and <i>ESR1</i> were higher in ADI ≥ 60.</p> Conclusions <p>We observed a trend towards worse OS in areas with high ADI, though not statistically significant. The incidence of germline testing was lower in high ADI compared to low ADI regions.</p>

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Area deprivation index and breast cancer outcomes among patients in Western New York

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月22日

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  • Malak Alharbi,
  • Jayasree Krishnan,
  • Arya Mariam Roy,
  • Archit Patel,
  • Ankita Kapoor,
  • Riya Patel,
  • Kayla Catalfamo,
  • Kristopher Attwood,
  • Han Yu,
  • Varsha Gupta,
  • Sheheryar Kabraji,
  • Kazuaki Takabe,
  • Thaer Khoury,
  • Ellis Levine,
  • Angela Omilian,
  • Elizabeth Bouchard,
  • Song Yao,
  • Shipra Gandhi

摘要

Background

Several studies have shown that residing in regions with high area deprivation index (ADI) is associated with worse outcomes. We evaluated associations between ADI and breast cancer (BC) outcomes among patients in Western New York (WNY), a region that includes multiple underserved areas.

Methods

This retrospective, single-institution study analyzed data from 404 BC patients diagnosed between 2014 and 2018. Demographic and clinicopathological data were abstracted. Data were compared between high (≥ 60) and low (< 60) ADI groups, reflective of high and low levels of socioeconomic disadvantage, respectively. The primary objective was overall survival (OS) by ADI. Secondary objectives included assessment of recurrence free survival (RFS) or time to next treatment (TNT) by ADI and frequency of germline and somatic testing.

Results

Over half of the patients (59%) resided in ADI ≥ 60. 77% of patients had stage I-III BC and 23% had de novo metastatic BC. Patients in ADI ≥ 60 had a lower 5-year OS rate (73%) than those in ADI < 60 (84%) (95%CI: 67.5–79.7, P = 0.05). In multivariable analysis, similar trend was observed but was not statistically significant (HR 1.56, 95%CI: 0.98–2.46, P = 0.058). There were no differences in TNT or RFS by ADI. Germline testing was performed less frequently (33%) in ADI ≥ 60 than ADI < 60 group (45%) (P = 0.04) for patients with stage I-III BC, while no difference observed for stage IV patients. Finally, prevalence of somatic mutations in TP53, PIK3CA, and ESR1 were higher in ADI ≥ 60.

Conclusions

We observed a trend towards worse OS in areas with high ADI, though not statistically significant. The incidence of germline testing was lower in high ADI compared to low ADI regions.