Area Deprivation May Worsen Survival Outcomes in Black Women With MBC

Black and White women with metastatic breast cancer (MBC) may experience different outcomes even when level of neighborhood deprivation is considered, according to results published in Oncology Nursing Forum.

Black women with triple-negative MBC experience shorter progression-free and overall survival than White women, researchers found, and White women may be less negatively affected by their surroundings even when living in areas of high deprivation.

In this retrospective review of electronic health records, researchers examined data from 54 women who had died from triple-negative MBC from November 2016 to April 2021, including 45 White women and 9 Black women. Patients’ area deprivation index was calculated based on their last listed address.

The Black women studied were more likely than the White women to live in areas with higher levels of deprivation, the researchers reported (P =.002).

Black women had a shorter time to first progression than White women, at 5.5 months and 8.2 months, respectively. Similarly, post-metastasis overall survival was 10.3 months in Black women and 18.4 months in White women. However, neither of these differences reached statistical significance.

When the researchers compared Black and White women living in higher-deprivation areas, Black women again had shorter survival times than White women. Time to first progression was 5.4 months for Black women and 9.1 months for White women with high levels of area deprivation. Post-metastasis overall survival in this patient population was 9.9 months for Black women and 24.6 months for White women.

Among women living in higher-deprivation areas, Black women also had higher levels of anxiety than White women based on scores on the Generalized Anxiety Disorder-7 questionnaire (9.3 vs 4.3, respectively).

Again, none of these results were statistically significant. “The lack of statistical significance was likely because of the study’s small sample size,” the researchers noted, adding that the differences in survival times were “clinically meaningful.”

“It is clear from these findings that race and racism must be considered as a distinct entity when evaluating neighborhoods with high deprivation,” the researchers concluded. “White women may be less affected by their neighborhood, even when living in areas of greater deprivation influencing cancer outcomes. This merits further exploration.”

Reference

Rosenzweig MQ,  Nugent B, McGuire M. Impact of race and area deprivation on triple-negative metastatic breast cancer outcomes. Oncol Nurs Forum. 2023;50(4):449-457. doi:10.1188/23.ONF.449-457