ArticleCancers2025
Neighborhood Disadvantage, Built Environment, and Breast Cancer Outcomes: Disparities in Tumor Aggressiveness and Survival.
Article in Cancers, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Census tract-level socioeconomic variables and breast cancer characteristics and outcomes in California and New York State.Cancer causes & control : CCC · 2026Article
- Comparable Access, Different Outcomes: Breast Cancer Survival Among Syrian Refugees and Turkish Patients in Türkiye.Current oncology (Toronto, Ont.) · 2026Article
- Health Insurance and Neighborhood Deprivation as Determinants of Diagnostic Delays and Survival in Breast Cancer.Healthcare (Basel, Switzerland) · 2026Article
- Allostatic Load Predicts Immune-Related Toxicity and Survival in Melanoma Patients Receiving Immune Checkpoint Inhibitors.Cancers · 2026Article
- A Geographically Sensitive Neighborhood Exposome-Wide Association Study for Breast Cancer Survival.JAMA network open · 2026Article
- Neighborhood deprivation, breast cancer outcomes and stress-related gene expression in leukocytes and tumor tissue.Breast cancer research : BCR · 2025Article
- Article
Corrections and comments
- Erratum issued
Authors and funding
10 authors.
Funding
Abstract
backgroundBreast cancer disparities persist globally, with growing evidence implicating neighborhood and built environmental factors in disease outcomes.
methodsThis study investigates the associations between neighborhood disadvantage, environmental exposures, and breast tumor characteristics and survival among 3041 stage I-III breast cancer patients treated at the University of Virginia Comprehensive Cancer Center (2014-2024). Neighborhood disadvantage was assessed via the Area Deprivation Index (ADI), while environmental exposures included PM2.5, green space (NDVI), and food indices (modified retail food environment index (mRFEI), retail food activity index (RFAI)). Multivariable regression and Cox models adjusted for demographic, socioeconomic, and clinical covariates were employed.
resultsA higher ADI score was associated with aggressive tumor characteristics, including advanced stage (Odds Ratio (OR) = 1.06, 95% Confidence Interval (CI):1.01-1.11), poor differentiation (OR = 1.07, 1.01-1.15), ER-negative status (OR = 1.06, 1.01-1.12), and triple-negative breast cancer (TNBC) (OR = 1.08, 1.02-1.16), as well as younger diagnosis age (β = -0.22, -0.36 to -0.09). PM2.5 exposure was correlated with advanced tumor stage (OR = 1.24, 1.09-1.40 for stage III) but paradoxically predicted improved survival (Hazard Ratio (HR) = 0.71, 0.63-0.82). The food environment indices showed subtype-specific survival benefits: higher mRFEI and RFAI scores were linked to reduced mortality in ER-negative (HR = 0.45, 0.23-0.85 and HR = 0.61, 0.38-0.97) and TNBC (HR = 0.40, 0.18-0.90 and HR = 0.48, 0.26-0.87) patients. NDVI scores exhibited no significant associations.
conclusionOur findings underscore the dual role of neighborhood disadvantage and the built environmental in breast cancer outcomes. While neighborhood disadvantage and PM2.5 exposure elevate tumor aggressiveness, survival disparities may be mediated by other factors. Improved food environments may enhance survival in aggressive subtypes, highlighting the need for integrated interventions addressing socioeconomic inequities, environmental risks, and nutritional support needs.
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