Neighborhood deprivation, breast cancer outcomes and stress-related gene expression in leukocytes and tumor tissue
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Neighborhood socioeconomic deprivation is a recognized contributor to disparities in breast cancer outcomes, yet the biological mechanisms linking neighborhood context to tumor behavior remain poorly defined. The conserved transcriptional response to adversity (CTRA), characterized by upregulation of pro-inflammatory genes and downregulation of type I interferon and antibody-related genes, may represent a stress-related immune dysregulation pathway relevant to cancer aggressiveness and survival. METHODS: We examined associations among the Area Deprivation Index (ADI), CTRA gene expression profiles, tumor characteristics, and survival outcomes across two cohorts. Cohort 1 included 467 breast cancer patients treated at M.D. Anderson Cancer Center, with RNA-seq data from peripheral leukocytes used to evaluate associations of ADI with CTRA and tumor characteristics at baseline. Cohort 2 comprised 1082 TCGA breast cancer patients with RNA-seq data from tumor tissue analyzed to assess the prognostic relevance of CTRA. CTRA scores were calculated using established gene signatures. Multivariable regression and Cox proportional hazards models were applied. RESULTS: In Cohort 1, higher ADI was significantly associated with elevated CTRA and pro-inflammatory gene expression in leukocytes (ρ = 0.082, p = 0.01). These immune profiles correlated with ER-negative status, stage III disease, and poor tumor differentiation. In TCGA (Cohort 2), elevated tumor CTRA expression was independently associated with worse overall survival (HR = 1.36, 95% CI: 1.04, 1.78, p = 0.02). CONCLUSIONS: These findings suggest that neighborhood socioeconomic disadvantage may influence systemic immune regulation through stress-related transcriptional responses, which in turn contribute to tumor aggressiveness and survival disparities in breast cancer.
Source: Breast Cancer Research
Institutions: University of Virginia, Virginia Commonwealth University
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,190
Award: G4281429
OpenAlex ID: W4415849111
