Evaluation of the association of area-level socioeconomic deprivation and breast cancer recurrence by oestrogen receptor subtypes in Scotland
Abstract Background Women from socioeconomically deprived areas have lower breast cancer (BC) incidence rates for screen-detected oestrogen receptor (ER) + tumours and higher mortality for select tumour subtypes. We aimed to determine if ipsilateral breast cancer recurrence (IBR) differs by Scottish...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-10-01
|
| Series: | Breast Cancer Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13058-023-01704-6 |
| _version_ | 1797555503506653184 |
|---|---|
| author | Hayley M. Dunlop Linda J. Williams Peter S. Hall Matthew Barber Christine Dodds Jonine D. Figueroa |
| author_facet | Hayley M. Dunlop Linda J. Williams Peter S. Hall Matthew Barber Christine Dodds Jonine D. Figueroa |
| author_sort | Hayley M. Dunlop |
| collection | DOAJ |
| description | Abstract Background Women from socioeconomically deprived areas have lower breast cancer (BC) incidence rates for screen-detected oestrogen receptor (ER) + tumours and higher mortality for select tumour subtypes. We aimed to determine if ipsilateral breast cancer recurrence (IBR) differs by Scottish Index of Multiple Deprivation (SIMD) quintile and tumour subtype in Scotland. Methods Patient data for primary invasive BC diagnosed in 2007–2008 in Scotland was analysed. Manual case-note review for 3495 patients from 10 years post-diagnosis was used. To determine the probability of IBR while accounting for the competing risk of death from any cause, cumulative incidence functions stratified by ER subtype and surgery were plotted. Multivariable Cox Proportional Hazards models were used to estimate the association of SIMD accounting for other predictors of IBR. Results Among 2819 ER + tumours, 423 patients had a recurrence and 438 died. SIMD was related to death (p = 0.018) with the most deprived more likely to have died in the 10-year period (17.7% vs. 12.9%). We found no significant differences by SIMD in prognostic tumour characteristics (grade, TNM stage, treatment, screen-detection) or risk of IBR. Among 676 patients diagnosed with ER- tumours, 105 died and 185 had a recurrence. We found no significant differences in prognostic tumour characteristics by SIMD except screen detection with the most deprived more likely than the least to have their tumours detected from screening (46.9% vs. 28%, p = 0.03). Among patients with ER- tumours, 50% had mastectomy and the most deprived had increased 5-year IBR risk compared to the least deprived (HR 3.03 [1.41–6.53]). Conclusions IBR is not a major contributor to mortality differences by SIMD for the majority of BC patients in our study. The lack of inequities in IBR are likely due to standardised treatment protocols and access to healthcare. The association with socioeconomic deprivation and recurrence for ER- tumours requires further study. |
| first_indexed | 2024-03-10T16:48:27Z |
| format | Article |
| id | doaj.art-12609a3f6eb040208ee9fa696bd8dd26 |
| institution | Directory Open Access Journal |
| issn | 1465-542X |
| language | English |
| last_indexed | 2024-03-10T16:48:27Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Breast Cancer Research |
| spelling | doaj.art-12609a3f6eb040208ee9fa696bd8dd262023-11-20T11:22:13ZengBMCBreast Cancer Research1465-542X2023-10-0125111310.1186/s13058-023-01704-6Evaluation of the association of area-level socioeconomic deprivation and breast cancer recurrence by oestrogen receptor subtypes in ScotlandHayley M. Dunlop0Linda J. Williams1Peter S. Hall2Matthew Barber3Christine Dodds4Jonine D. Figueroa5The Ohio State University College of MedicineEdinburgh Clinical Trials Unit, The Usher Institute, The University of EdinburghInstitute of Genetics and Cancer, University of EdinburghEdinburgh Breast Unit, NHS Lothian, Western General HospitalSoutheast Scotland Cancer Network (SCAN)Centre for Global Health, The Usher Institute, The University of EdinburghAbstract Background Women from socioeconomically deprived areas have lower breast cancer (BC) incidence rates for screen-detected oestrogen receptor (ER) + tumours and higher mortality for select tumour subtypes. We aimed to determine if ipsilateral breast cancer recurrence (IBR) differs by Scottish Index of Multiple Deprivation (SIMD) quintile and tumour subtype in Scotland. Methods Patient data for primary invasive BC diagnosed in 2007–2008 in Scotland was analysed. Manual case-note review for 3495 patients from 10 years post-diagnosis was used. To determine the probability of IBR while accounting for the competing risk of death from any cause, cumulative incidence functions stratified by ER subtype and surgery were plotted. Multivariable Cox Proportional Hazards models were used to estimate the association of SIMD accounting for other predictors of IBR. Results Among 2819 ER + tumours, 423 patients had a recurrence and 438 died. SIMD was related to death (p = 0.018) with the most deprived more likely to have died in the 10-year period (17.7% vs. 12.9%). We found no significant differences by SIMD in prognostic tumour characteristics (grade, TNM stage, treatment, screen-detection) or risk of IBR. Among 676 patients diagnosed with ER- tumours, 105 died and 185 had a recurrence. We found no significant differences in prognostic tumour characteristics by SIMD except screen detection with the most deprived more likely than the least to have their tumours detected from screening (46.9% vs. 28%, p = 0.03). Among patients with ER- tumours, 50% had mastectomy and the most deprived had increased 5-year IBR risk compared to the least deprived (HR 3.03 [1.41–6.53]). Conclusions IBR is not a major contributor to mortality differences by SIMD for the majority of BC patients in our study. The lack of inequities in IBR are likely due to standardised treatment protocols and access to healthcare. The association with socioeconomic deprivation and recurrence for ER- tumours requires further study.https://doi.org/10.1186/s13058-023-01704-6Breast cancerRecurrenceDisparities |
| spellingShingle | Hayley M. Dunlop Linda J. Williams Peter S. Hall Matthew Barber Christine Dodds Jonine D. Figueroa Evaluation of the association of area-level socioeconomic deprivation and breast cancer recurrence by oestrogen receptor subtypes in Scotland Breast Cancer Research Breast cancer Recurrence Disparities |
| title | Evaluation of the association of area-level socioeconomic deprivation and breast cancer recurrence by oestrogen receptor subtypes in Scotland |
| title_full | Evaluation of the association of area-level socioeconomic deprivation and breast cancer recurrence by oestrogen receptor subtypes in Scotland |
| title_fullStr | Evaluation of the association of area-level socioeconomic deprivation and breast cancer recurrence by oestrogen receptor subtypes in Scotland |
| title_full_unstemmed | Evaluation of the association of area-level socioeconomic deprivation and breast cancer recurrence by oestrogen receptor subtypes in Scotland |
| title_short | Evaluation of the association of area-level socioeconomic deprivation and breast cancer recurrence by oestrogen receptor subtypes in Scotland |
| title_sort | evaluation of the association of area level socioeconomic deprivation and breast cancer recurrence by oestrogen receptor subtypes in scotland |
| topic | Breast cancer Recurrence Disparities |
| url | https://doi.org/10.1186/s13058-023-01704-6 |
| work_keys_str_mv | AT hayleymdunlop evaluationoftheassociationofarealevelsocioeconomicdeprivationandbreastcancerrecurrencebyoestrogenreceptorsubtypesinscotland AT lindajwilliams evaluationoftheassociationofarealevelsocioeconomicdeprivationandbreastcancerrecurrencebyoestrogenreceptorsubtypesinscotland AT petershall evaluationoftheassociationofarealevelsocioeconomicdeprivationandbreastcancerrecurrencebyoestrogenreceptorsubtypesinscotland AT matthewbarber evaluationoftheassociationofarealevelsocioeconomicdeprivationandbreastcancerrecurrencebyoestrogenreceptorsubtypesinscotland AT christinedodds evaluationoftheassociationofarealevelsocioeconomicdeprivationandbreastcancerrecurrencebyoestrogenreceptorsubtypesinscotland AT joninedfigueroa evaluationoftheassociationofarealevelsocioeconomicdeprivationandbreastcancerrecurrencebyoestrogenreceptorsubtypesinscotland |