Socioeconomic Status and Incidence of Breast Cancer by Hormone Receptor Subtype

Overview

Journal Springerplus

Date 2015 Sep 26

PMID 26405628

Citations 54

Authors

Tomi F Akinyemiju

Maria Pisu

John W Waterbor

Sean F Altekruse

Affiliations

Soon will be listed here.

Abstract

Recent developments in genetics and molecular biology have classified breast cancer into subtypes based on tumor markers of estrogen (ER), progesterone (PR) and human epidermal growth Factor-2 receptors (Her-2), with the basal-like (ER-, PR-, Her2-) subtype commonly referred to as "triple negative" breast cancer (TNBC) being the most aggressive. Prior studies have provided evidence that higher socio-economic status (SES) is associated with increased breast cancer risk, likely due to hormone related risk factors such as parity and hormonal contraceptive use. However, it is unclear if the relationship between SES and overall breast cancer incidence exists within each subtype, and if this association varies by race/ethnicity. Analysis was based on data obtained from the SEER database linked to 2008-2012 American Community Survey data, and restricted to women diagnosed with breast cancer in 2010. The NCI SES census tract SES index based on measures of income, poverty, unemployment, occupational class, education and house value, was examined and categorized into quintiles. Age-adjusted incidence rate ratios were calculated comparing the lowest to the highest SES groups by subtype, separately for each race/ethnic group. We identified 47,586 women with breast cancer diagnosed in 2010. The majority was diagnosed with Her2-/HR+ tumors (73 %), while 12 % had triple negative tumors (TNBC). There was a significant trend of higher incidence with increasing SES for Her2-/HR+ (IRR Highest vs. Lowest SES: 1.32, 95 % CI 1.27-1.39; p value trend: 0.01) and Her2+/HR+ tumors (IRR Highest vs. Lowest SES: 1.46, 95 % CI 1.27-1.68; p value trend: 0.01) among White cases. There was no association between SES and incidence of HR- subtypes (Her2+/HR- or TNBC). Similar associations were observed among Black, Hispanic and Asian or Pacific Islander cases. The positive association between SES and breast cancer incidence is primarily driven by hormone receptor positive tumors. To the extent that neighborhood SES is a proxy for individual SES, future studies are still needed to identify etiologic risk factors for other breast cancer subtypes.

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References

Martinez S, Blanco E, Delva J, Burrows R, Reyes M, Lozoff B . Perception of neighborhood crime and drugs increases cardiometabolic risk in Chilean adolescents. J Adolesc Health. 2014; 54(6):718-23. PMC: 4035454. DOI: 10.1016/j.jadohealth.2013.10.207. View

Gukas I, Girling A, Mandong B, Prime W, Jennings B, Leinster S . A comparison of clinicopathological features and molecular markers in british and nigerian women with breast cancer. Clin Med Oncol. 2011; 2:347-51. PMC: 3161669. DOI: 10.4137/cmo.s474. View

Singh G, Kogan M, Dee D . Nativity/immigrant status, race/ethnicity, and socioeconomic determinants of breastfeeding initiation and duration in the United States, 2003. Pediatrics. 2007; 119 Suppl 1:S38-46. DOI: 10.1542/peds.2006-2089G. View

Stark A, Kleer C, Martin I, Awuah B, Nsiah-Asare A, Takyi V . African ancestry and higher prevalence of triple-negative breast cancer: findings from an international study. Cancer. 2010; 116(21):4926-32. PMC: 3138711. DOI: 10.1002/cncr.25276. View

Borugian M, Spinelli J, Abanto Z, Xu C, Wilkins R . Breast cancer incidence and neighbourhood income. Health Rep. 2011; 22(2):7-13. View

Kelsey J, Gammon M, John E . Reproductive factors and breast cancer. Epidemiol Rev. 1993; 15(1):36-47. DOI: 10.1093/oxfordjournals.epirev.a036115. View

Clark C, Ommerborn M, Hickson D, Grooms K, Sims M, Taylor H . Neighborhood disadvantage, neighborhood safety and cardiometabolic risk factors in African Americans: biosocial associations in the Jackson Heart study. PLoS One. 2013; 8(5):e63254. PMC: 3653956. DOI: 10.1371/journal.pone.0063254. View

Vainshtein J . Disparities in breast cancer incidence across racial/ethnic strata and socioeconomic status: a systematic review. J Natl Med Assoc. 2008; 100(7):833-9. DOI: 10.1016/s0027-9684(15)31378-x. View

Vargas-Hernandez V, Vargas-Aguilar V, Moreno-Eutimio M, Acosta-Altamirano G, Tovar-Rodriguez J . Metabolic syndrome in breast cancer. Gland Surg. 2014; 2(2):80-90. PMC: 4115738. DOI: 10.3978/j.issn.2227-684X.2013.04.02. View

10.

Parise C, Bauer K, Brown M, Caggiano V . Breast cancer subtypes as defined by the estrogen receptor (ER), progesterone receptor (PR), and the human epidermal growth factor receptor 2 (HER2) among women with invasive breast cancer in California, 1999-2004. Breast J. 2009; 15(6):593-602. DOI: 10.1111/j.1524-4741.2009.00822.x. View

11.

Morris G, Mitchell E . Higher incidence of aggressive breast cancers in African-American women: a review. J Natl Med Assoc. 2008; 100(6):698-702. DOI: 10.1016/s0027-9684(15)31344-4. View

12.

Sineshaw H, Gaudet M, Ward E, Flanders W, DeSantis C, Lin C . Association of race/ethnicity, socioeconomic status, and breast cancer subtypes in the National Cancer Data Base (2010-2011). Breast Cancer Res Treat. 2014; 145(3):753-63. DOI: 10.1007/s10549-014-2976-9. View

13.

Phipps A, Chlebowski R, Prentice R, McTiernan A, Wactawski-Wende J, Kuller L . Reproductive history and oral contraceptive use in relation to risk of triple-negative breast cancer. J Natl Cancer Inst. 2011; 103(6):470-7. PMC: 3057984. DOI: 10.1093/jnci/djr030. View

14.

Kitsantas P, Gaffney K, Kornides M . Prepregnancy body mass index, socioeconomic status, race/ethnicity and breastfeeding practices. J Perinat Med. 2011; 40(1):77-83. PMC: 4241959. DOI: 10.1515/JPM.2011.106. View

15.

Ambrosone C, Zirpoli G, Ruszczyk M, Shankar J, Hong C, McIlwain D . Parity and breastfeeding among African-American women: differential effects on breast cancer risk by estrogen receptor status in the Women's Circle of Health Study. Cancer Causes Control. 2013; 25(2):259-65. PMC: 3903305. DOI: 10.1007/s10552-013-0323-9. View

16.

Krieger N, Chen J, Waterman P . Decline in US breast cancer rates after the Women's Health Initiative: socioeconomic and racial/ethnic differentials. Am J Public Health. 2010; 100 Suppl 1:S132-9. PMC: 2837433. DOI: 10.2105/AJPH.2009.181628. View

17.

Flacking R, Wallin L, Ewald U . Perinatal and socioeconomic determinants of breastfeeding duration in very preterm infants. Acta Paediatr. 2007; 96(8):1126-30. DOI: 10.1111/j.1651-2227.2007.00386.x. View

18.

Lund M, Butler E, Hair B, Ward K, Andrews J, Oprea-Ilies G . Age/race differences in HER2 testing and in incidence rates for breast cancer triple subtypes: a population-based study and first report. Cancer. 2010; 116(11):2549-59. DOI: 10.1002/cncr.25016. View

19.

Mosher W, Jones J, Abma J . Intended and unintended births in the United States: 1982-2010. Natl Health Stat Report. 2012; (55):1-28. View

20.

Clarke C, Keegan T, Yang J, Press D, Kurian A, Patel A . Age-specific incidence of breast cancer subtypes: understanding the black-white crossover. J Natl Cancer Inst. 2012; 104(14):1094-101. PMC: 3640371. DOI: 10.1093/jnci/djs264. View