Abstract
BACKGROUNDWomen living in disadvantaged neighborhoods present with increased prevalence rates of triple negative breast cancer (TNBC). This study takes a spatial-temporal epidemiological approach to understand the impact of socio-environmental contextual factors on TNBC prevalence rates.METHODSWe analyzed 935 TNBC cases from a major cancer center registry, between 2005 and 2017, to explore spatial and space-time clusters of TNBC prevalence rates at the census tract and neighborhood scales. Spatial regression analysis was performed to examine relationships between nine socio-environmental factors and TNBC prevalence rates at both ecological scales.RESULTSWe observed statistically significant spatial clustering of high TNBC prevalence rates along a north-south corridor of Miami-Dade County along Interstate 95, a region containing several majority non-Hispanic Black neighborhoods that have been historically marginalized. Among the ecological measures, the percent of a region designated as a brownfield (hazardous waste facilities) was significantly associated with TNBC prevalence rates at the tract- (β = 4.27, SE = 1.08, P < 0.001) and neighborhood-level (β = 8.61, SE = 2.20, P < 0.001).CONCLUSIONSOur novel spatial-temporal analysis identified robust patterns of hot spots of TNBC prevalence rates in a corridor of several disadvantaged neighborhoods in the northern half of the county. These patterns of TNBC align with the literature regarding at-risk groups and neighborhood-level effects on TNBC.IMPACTSpatial epidemiological approaches can help public health officials and cancer care providers improve place-specific screening, patient care, and our understanding of socio-environmental factors that may shape breast cancer subtype through gene-environment and epigenetic interactions.
