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

Siegel, Scott D.; Brooks, Madeline; Lynch, Shannon M.; Sims‐Mourtada, Jennifer; Schug, Zachary T.; Curriero, Frank C.

doi:10.1186/s13058-022-01533-z

Cited by 21 publications

(20 citation statements)

References 66 publications

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“…In conclusion, the results from this study extend prior research that has documented a relationship between general neighborhood characteristics (i.e., SES, segregation) and TNBC risk 28,29,47…”

Section: Discussionsupporting

confidence: 85%

“…63 Patient addresses were geocoded with ArcGIS 10.8, 61 yielding a 95% match rate. As described elsewhere, 47 unmatched patients did not significantly differ from matched patients on demographic or clinical characteristics.…”

Section: Methodsmentioning

confidence: 72%

“…This was likely due to insufficient between-tract variation to support estimation of a tract-level random effect, as described in more detail elsewhere. 47 Figure 1 visualizes the relationship between cumulative exposure and risk of TNBC. Figure 1A depicts the unadjusted relationship between the cumulative exposure risk score and TNBC odds aggregated to the census tract.…”

Section: Resultsmentioning

confidence: 99%

“…When these analyses were attempted with a multivariate mixed‐effects model, it resulted in a singular fit and coefficients could not be estimated (see Table S4). This was likely due to insufficient between‐tract variation to support estimation of a tract‐level random effect, as described in more detail elsewhere 47 …”

Section: Resultsmentioning

confidence: 99%

“…However, given the well‐documented higher rates of TNBC observed for Black women, we could not rule out that the TNBC hot spots truly reflected neighborhood effects and not simply geographic areas composed of individuals who were at greater individual risk of TNBC 46 . In a second multilevel spatial study that adjusted for patient‐level race, we observed that women in predominantly Black census tracts were at greater risk of TNBC, suggesting that neighborhood context contributed to TNBC risk 47 . We additionally found preliminary support for disparate exposure to specific contextual factors (e.g., alcohol retailer density 48 ) within predominantly Black/high‐risk TNBC census tracts that have been shown to influence patient‐level exposure to TNBC risk factors (e.g., unhealthy alcohol use 49,50 ).…”

Section: Introductionmentioning

confidence: 83%

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Neighborhood factors and triple negative breast cancer: The role of cumulative exposure to area‐level risk factors

et al. 2023

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Background: Despite similar incidence rates among Black and White women, breast cancer mortality rates are 40% higher among Black women. More than half of the racial difference in breast cancer mortality can be attributed to triple negative breast cancer (TNBC), an aggressive subtype of invasive breast cancer that disproportionately affects Black women. Recent research has implicated neighborhood conditions in the etiology of TNBC. This study investigated the relationship between cumulative neighborhood-level exposures and TNBC risk. Methods: This single-institution retrospective study was conducted on a cohort of 3316 breast cancer cases from New Castle County, Delaware (from 2012 to 2020), an area of the country with elevated TNBC rates. Cases were stratified into TNBC and "Non-TNBC" diagnosis and geocoded by residential address. Neighborhood exposures included census tract-level measures of unhealthy alcohol use, metabolic dysfunction, breastfeeding, and environmental hazards. An overall cumulative risk score was calculated based on tract-level exposures.Results: Univariate analyses showed each tract-level exposure was associated with greater TNBC odds. In multivariate analyses that controlled for patientlevel race and age, tract-level exposures were not associated with TNBC odds. However, in a second multivariate model that included patient-level variables and considered tract-level risk factors as a cumulative exposure risk score, each one unit increase in cumulative exposure was significantly associated with a 10% increase in TNBC odds. Higher cumulative exposure risk scores were found in census tracts with relatively high proportions of Black residents. Conclusions:Cumulative exposure to neighborhood-level risk factors that disproportionately affect Black communities was associated with greater TNBC risk.

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Section: Discussionsupporting

confidence: 85%

Section: Methodsmentioning

confidence: 72%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 83%

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Neighborhood factors and triple negative breast cancer: The role of cumulative exposure to area‐level risk factors

et al. 2023

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Screening for Breast Cancer

Nicholson,

Silverstein,

Wong

et al. 2024

JAMA

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ImportanceAmong all US women, breast cancer is the second most common cancer and the second most common cause of cancer death. In 2023, an estimated 43 170 women died of breast cancer. Non-Hispanic White women have the highest incidence of breast cancer and non-Hispanic Black women have the highest mortality rate.ObjectiveThe USPSTF commissioned a systematic review to evaluate the comparative effectiveness of different mammography-based breast cancer screening strategies by age to start and stop screening, screening interval, modality, use of supplemental imaging, or personalization of screening for breast cancer on the incidence of and progression to advanced breast cancer, breast cancer morbidity, and breast cancer–specific or all-cause mortality, and collaborative modeling studies to complement the evidence from the review.PopulationCisgender women and all other persons assigned female at birth aged 40 years or older at average risk of breast cancer.Evidence AssessmentThe USPSTF concludes with moderate certainty that biennial screening mammography in women aged 40 to 74 years has a moderate net benefit. The USPSTF concludes that the evidence is insufficient to determine the balance of benefits and harms of screening mammography in women 75 years or older and the balance of benefits and harms of supplemental screening for breast cancer with breast ultrasound or magnetic resonance imaging (MRI), regardless of breast density.RecommendationThe USPSTF recommends biennial screening mammography for women aged 40 to 74 years. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women 75 years or older. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of supplemental screening for breast cancer using breast ultrasonography or MRI in women identified to have dense breasts on an otherwise negative screening mammogram. (I statement)

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Exploring Racial Disparities in Triple-Negative Breast Cancer: Insights from Feature Selection Algorithms

Sahoo,

Adeyeha,

Pinnix

et al. 2023

Lecture Notes in Computer Science

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

Cited by 21 publications

References 66 publications

Neighborhood factors and triple negative breast cancer: The role of cumulative exposure to area‐level risk factors

Neighborhood factors and triple negative breast cancer: The role of cumulative exposure to area‐level risk factors

Screening for Breast Cancer

Exploring Racial Disparities in Triple-Negative Breast Cancer: Insights from Feature Selection Algorithms

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