Prevalence of advanced breast cancer, diabetes, obesity, and metabolic syndrome is greater among black women compared with white women. Metabolic syndrome is associated with worse breast cancer prognosis and has been linked to socioeconomic status. However, it is unclear how the subjective perception of social status (SSS) might affect these associations.
All 1206 participants enrolled had a new breast cancer diagnosis. The women were an average age of 58 years, 295 were black and 911 were white. Breast cancer was stage ≥II in 37.1% of black women and 18.5% of white women. All patients were surveyed, provided a serum sample for analysis, and measured for height and weight. On average, black women had higher body mass index (P <.001) and waist circumference (P <.001). Triglycerides, systolic blood pressure, waist circumference, high-density lipoprotein, and glucose measurements were used to determine a severity index of metabolic syndrome. Black women also had higher glucose (P <.001) and systolic blood pressure (P <.001) but lower triglycerides (P <.001) and high-density lipoprotein (P <.001). The participants reported SSS, their household income, education attained, quality of diet on a 5-point scale, and exercise. Compared with white women, black women were more likely than white women to live in poverty (P <.001), report poor diet (P <.001), exercise less, and unlikely to graduate college. Metabolic syndrome severity index scores were positively associated with age (P <.001) and being black (P <.001), and negatively with better diet (P <.001), exercise (P <.001), and SSS (P = .004). SSS was lower in black women within the same levels of income and education as white women.
Metabolic syndrome is a risk factor for poor breast cancer prognosis. Race, diet, exercise, and subjective social status intersect to negatively impact disease outcomes. Black women with breast cancer are more likely to report lower SSS than white women, which is associated with metabolic syndrome. Therefore, the results emphasize the importance of considering perception of social status as a risk factor among breast cancer patients, especially black women.
Source: Greco G, Gallagher EJ, Leroith D, et al. Race, subjective social status and metabolic syndrome in women with breast cancer. American Society of Clinical Oncology Virtual Meeting; June 4-8, 2021. Abstract 560.