학술논문

Area Deprivation Index in patients with invasive lobular carcinoma of the breast: associations with tumor characteristics and outcomes
Document Type
article
Source
Cancer Epidemiology Biomarkers & Prevention. 32(8)
Subject
Biomedical and Clinical Sciences
Health Sciences
Oncology and Carcinogenesis
Cancer
Breast Cancer
Female
Humans
Breast Neoplasms
Carcinoma
Ductal
Breast
Carcinoma
Lobular
Progression-Free Survival
Retrospective Studies
Residence Characteristics
Socioeconomic Factors
Social Deprivation
Healthcare Disparities
Middle Aged
Medical and Health Sciences
Epidemiology
Biomedical and clinical sciences
Health sciences
Language
Abstract
BackgroundAlthough investigators have shown associations between socioeconomic status (SES) and outcomes in breast cancer, there is a paucity of such data for invasive lobular carcinoma (ILC), the second most common type of breast cancer. Herein we evaluated the relationship between SES with tumor features and outcomes in stage I to III patients with ILC.MethodsWe analyzed a prospectively maintained institutional ILC database and utilized the area deprivation index (ADI) to determine neighborhood adversity, an indicator of SES. We used Cox proportional hazards models in Stata 17.0 to evaluate relationships between ADI quintile (Q), race, body mass index (BMI), clinicopathologic features, treatment type, and event-free survival (EFS).ResultsOf 804 patients with ILC, 21.4% lived in neighborhoods classified as ADI Q1 (least resource-deprived) and 19.7% in Q5 (most resource-deprived). Higher deprivation was significantly associated with larger tumor size (3.6 cm in Q5 vs. 3.1 cm in Q1), increased presence of lymphovascular invasion (8.9% in Q5 vs. 6.7% in Q1), and decreased use of adjuvant endocrine therapy (67.1% in Q5 vs. 73.6% in Q1). On multivariable analysis, tumor size, receptor subtypes, and omission of adjuvant endocrine therapy were associated with reduced EFS.ConclusionsThese data show that patients with ILC and higher ADI experience more aggressive tumors and differences in treatment. More data evaluating the complex relationships between these factors is needed to optimize outcomes for patients with ILC, regardless of SES.ImpactADI is associated with differences in patients with ILC.