Social, biological, and tumor characteristics of 139 African American (AA) women with newly diagnosed breast cancer in Chicago.

Abstract

6064 Background: Previous work by our group has shown that social isolation, social stress, and increased vigilance are associated with larger and more aggressive mammary tumors in animal models. In this study, we seek to better characterize these relationships among AA women with newly diagnosed breast cancer. Methods: AA women newly diagnosed with breast cancer were recruited from 3 hospitals in the Chicago area from 2005-2009. Women underwent in-home interviews which focused on psychosocial functioning and social networks. In addition, 4 daily salivary cortisol samples were self-collected over a 3 day period. Additional neighborhood and community level data were collected using direct neighborhood mapping and geocoded information. Tumor samples were analyzed by IHC for ER, PR, HER2 and glucocorticoid receptor (GR) status. Results: 139 women were included in the sample. Median age 52. Stage: 5%DCIS, 29% I, 31% II, 30% III, 5% IV. 34% were triple negative (TN) and of 71 evaluable cases, 64% were GR+. GR status was associated with invasive cancer (69% invasive cancers GR+ vs. 29% of DCIS cases). 32% of pts were clinically depressed, 68% had moved in the previous 10 years, 31% had suffered a sexual assault, and loneliness scores were higher than a same-race Cook County control sample. In multivariate modeling, number of sexual assaults in the neighborhood was associated with estrogen-receptor (ER) negative status (b = -0.189, p < 0.05) and poorer histological grade of tumor (b = 0.143, p < 0.05). Felt loneliness was associated with HER2neu receptor negative status (b = -0.096, p < 0.05). 67% of patients had no diurnal cortisol variation (flat response) and cortisol group (flat versus circadian) was significantly associated with the individual factors mentioned above. Conclusions: AA women have high rates of TN tumors and GR+ tumors which is being recognized as an additional poor prognostic factor. They also suffer from numerous social stressors which appear to be linked to tumor biology and a flattened stress response. Continued work on understanding the interaction of these social variables and stress response on tumor biology and adherence to therapy is needed. No significant financial relationships to disclose.