Social Determinants Have Clinically Meaningful Effects on Breast Cancer Outcomes

October 11, 2023 by Elisa Becze BA, ELS, Editor

A patient’s race and the neighborhood in which they live can meaningfully lower time to progression and overall survival for triple-negative metastatic breast cancer, oncology nurse researchers reported (https://doi.org/10.1188/23.ONF.449-457) in the Oncology Nursing Forum.

The research team, which included ONS members Margaret Quinn Rosenzweig, PhD, FNP-BC, AOCNP^®, FAAN, and Meaghan McGuire, MSN, RN, CRNP, BC, conducted a cohort study to evaluate evidence from a database of 53 patients who had died from triple-negative metastatic breast cancer from 2016–2021. They calculated postmetastasis time to first progression and overall survival in number of days from metastatic diagnosis and identified patients’ area deprivation index (ADI) using the University of Wisconsin School of Medicine and Public Health’s Neighborhood Atlas website (https://www.neighborhoodatlas.medicine.wisc.edu/).

After comparing the statistics by patients’ race (Black versus White) and ADI (low versus high), they found that Black patients had higher levels of anxiety (9.3 versus 4.3), lived in more deprived areas (ADI of 80.3 versus 74.3), experienced poorer survival (5.4 versus 9.1 months for first progression and 9.9 versus 24.6 months for overall survival) than White patients.

“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 wrote (https://doi.org/10.1188/23.ONF.449-457). “Structurally, the redlining practices that were present in the United States since the 1930s through activities of the Home Owners’ Loan Corporation and Federal Housing Administration are foundational to the existence of deeply racially segregated, economically deprived neighborhoods that have been found to contribute to poor health outcomes.”

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