ArticleNPJ breast cancer2026
Neighborhood deprivation and oncotype DX recurrence scores among Black and White women: the interplay between race, place, and tumor biology.
Article in NPJ breast cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Breast cancer mortality disparities have persisted between non-Hispanic Black (NHB) and non-Hispanic White (NHW) women, even among those with prognostically favorable disease. The Oncotype DX Recurrence Score (ODX RS) is a gene expression panel used to identify estrogen receptor (ER)-positive breast cancers with aggressive tumor biology, and prior studies suggest higher scores among Black women and in lower-socioeconomic areas. We examined associations of neighborhood deprivation with ODX RS among 11,377 NHB and NHW women diagnosed with ER-positive breast cancer (stage I-IIIa, ≤3 lymph nodes) between 2010-2017 in the Georgia Cancer Registry. The Neighborhood Deprivation Index (NDI), derived via principal component analysis of American Community Survey block-group data, was assessed in quartiles. Prevalence ratios (PR) and 95% confidence intervals (CI) were estimated for high-risk (≥31) versus low-risk (<18) ODX RS. Living in the most deprived neighborhoods was modestly associated with high-risk ODX RS overall (PR = 1.08, 95% CI 0.90-1.30) and among NHW women (PR = 1.12, 95% CI 0.87-1.44), but not among NHB women (PR = 1.01, 95% CI 0.77-1.33). NHB women in the least deprived neighborhoods had the highest prevalence of high-risk ODX RS relative to NHW women in those neighborhoods (PR = 1.92, 95% CI 1.53-2.41). These findings suggest neighborhood deprivation does not explain racial differences in genomic risk.
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