Abstract
BackgroundA study from Scotland reported that the p53 mutation frequency in breast tumors is associated with socio-economic deprivation.MethodsWe analyzed the association of the tumor p53 mutational status with tumor characteristics, education, and self-reported annual household income (HI) among 173 breast cancer patients from the greater Baltimore area, United States.Resultsp53 mutational frequency was significantly associated with HI. Patients with < $15,000 HI had the highest p53 mutation frequency (21%), followed by the income group between $15,000 and $60,000 (18%), while those above $60,000 HI had the fewest mutations (5%). When dichotomized at $60,000, 26 out of 135 patients in the low income category had acquired a p53 mutation, while only 2 out of 38 with a high income carried a mutation (P < 0.05). In the adjusted logistic regression analysis with 3 income categories (trend test), the association between HI and p53 mutational status was independent of tumor characteristics, age, race/ethnicity, tobacco smoking and body mass. Further analyses revealed that HI may impact the p53 mutational frequency preferentially in patients who develop an estrogen receptor (ER)-negative disease. Within this group, 42% of the low income patients (< $15,000 HI) carried a mutation, followed by the middle income group (21%), while those above $60,000 HI did not carry mutations (P trend < 0.05).Conclusions:HI is associated with the p53 mutational frequency in patients who develop an ER-negative disease. Furthermore, high income patients may acquire fewer p53 mutations than other patients, suggesting that lifetime exposures associated with socio-economic status may impact breast cancer biology.
Highlights
Breast cancer incidence and mortality rates show large differences among population groups within the United States (US) and between more and less developed countries worldwide [1,2,3]
Our study found that household income (HI) was associated with the p53 mutation frequency in breast tumors, and high income patients may acquire fewer p53 mutations than other patients
We previously established a well characterized cohort of 143 African-American and 105 European-American breast cancer patients with information on the tumor p53 mutational status and survival follow-up [21]. This patient population was recruited in the greater Baltimore area in Maryland, US, and is representative of an inner city, low income community with a large minority population
Summary
We analyzed the association of the tumor p53 mutational status with tumor characteristics, education, and selfreported annual household income (HI) among 173 breast cancer patients from the greater Baltimore area, United States. When dichotomized at $60,000, 26 out of 135 patients in the low income category had acquired a p53 mutation, while only 2 out of 38 with a high income carried a mutation (P , 0.05). In the adjusted logistic regression analysis with 3 income categories (trend test), the association between HI and p53 mutational status was independent of tumor characteristics, age, race/ethnicity, tobacco smoking and body mass. Further analyses revealed that HI may impact the p53 mutational frequency preferentially in patients who develop an estrogen receptor (ER)-negative disease. Within this group, 42% of the low income patients (, $15,000 HI) carried a mutation, followed by the middle income group (21%), while those above $60,000 HI did not carry mutations (Ptrend , 0.05)
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