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Characterizing “collateral damage” in men and women with metastatic breast cancer (mBC) from diverse racial and ethnic backgrounds in New York City

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Abstract

Purpose

Patients from diverse racial, ethnic, and socio-economic backgrounds may be particularly vulnerable to experiencing undue social and financial burdens (“collateral damage”) from a metastatic breast cancer (mBC) diagnosis; however, these challenges have not been well explored in diverse populations.

Methods

From May 2022 to May 2023, English- or Spanish-speaking adults with mBC treated at four New York-Presbyterian (NYP) sites were invited to complete a survey that assessed collateral damage, social determinants of health, physical and psychosocial well-being, and patient-provider communication. Fisher’s exact and the Kruskal–Wallis rank-sum tests assessed differences by race and ethnicity.

Results

Of 87 respondents, 14% identified as Hispanic, 28% non-Hispanic Black (NHB), 41% non-Hispanic White (NHW), 7% Asian American Pacific Islander (AAPI), and 10% other/multiracial. While 100% of Hispanic, NHW, and AAPI participants reported stable housing, 29% of NHB participants were worried about losing housing (p = 0.002). Forty-two percent of Hispanic and 46% of NHB participants (vs. 8%, NHW and 0%, AAPI, p = 0.005) were food insecure; 18% of Hispanic and 17% of NHB adults indicated lack of reliable transportation in the last year (vs. 0%, NHW/AAPI, p = 0.033). Participants were generally satisfied with the quality of communication that they had with their healthcare providers and overall physical and mental well-being were modestly poorer relative to healthy population norms.

Conclusions

In our study, NHB and Hispanic mBC patients reported higher levels of financial concern and were more likely to experience food and transportation insecurity compared to NHW patients. Systematically connecting patients with resources to address unmet needs should be prioritized to identify feasible approaches to support economically vulnerable patients following an mBC diagnosis.

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Data and material availability

The data are not publicly available. Requests can be made to share data privately. However, any data sharing will require a formal data transfer agreement between the Weill Cornell Medicine and the other party. Requests to this effect should be directed to the corresponding author.

References

  1. Gogate A, Wheeler SB, Reeder-Hayes KE, Ekwueme DU, Fairley TL, Drier S, Trogdon JG (2021) Projecting the prevalence and costs of metastatic breast cancer from 2015 through 2030. JNCI Cancer Spectr 5(4):pkab063. https://doi.org/10.1093/jncics/pkab063

    Article  PubMed  PubMed Central  Google Scholar 

  2. Mariotto AB, Etzioni R, Hurlbert M, Penberthy L, Mayer M (2017) Estimation of the number of women living with metastatic breast cancer in the United States. Cancer Epidemiol Biomarkers Prev 26(6):809–815. https://doi.org/10.1158/1055-9965.EPI-16-0889

    Article  PubMed  PubMed Central  Google Scholar 

  3. Love SM, Bernstein L, Obidegwu O, Ottenbacher A, Eshraghi L, Clague J (2017) Collateral damage from metastatic breast cancer—preliminary results. Cancer Res. https://doi.org/10.1158/1538-7445.SABCS16-P4-20-03

    Article  Google Scholar 

  4. Williamson TJ, Love SM, Clague DeHart JN, Jorge-Miller A, Eshraghi L, Cooper Ortner H, Stanton AL (2018) Metastatic Breast Cancer Collateral Damage Project (MBCCD): scale development and preliminary results of the Survey of Health, Impact, Needs, and Experiences (SHINE). Breast Cancer Res Treat 171(1):75–84. https://doi.org/10.1007/s10549-018-4823-x

    Article  PubMed  PubMed Central  Google Scholar 

  5. Williams RB, Barefoot JC, Califf RM, Haney TL, Saunders WB, Pryor DB, Hlatky MA, Siegler IC, Mark DB (1992) Prognostic importance of social and economic resources among medically treated patients with angiographically documented coronary artery disease. JAMA 267(4):520–524

    Article  CAS  PubMed  Google Scholar 

  6. Gierisch JM, Earp JA, Brewer NT, Rimer BK (2010) Longitudinal predictors of nonadherence to maintenance of mammography. Cancer Epidemiol Biomarkers Prev 19(4):1103–1111. https://doi.org/10.1158/1055-9965.EPI-09-1120

    Article  PubMed  PubMed Central  Google Scholar 

  7. https://www.cms.gov/priorities/innovation/files/worksheets/ahcm-screeningtool.pdf. Accessed 14 Nov 2023

  8. Reeve BB, Thissen DM, Bann CM, Mack N, Treiman K, Sanoff HK, Roach N, Magnus BE, He J, Wagner LK et al (2017) Psychometric evaluation and design of patient-centered communication measures for cancer care settings. Patient Educ Couns 100(7):1322–1328. https://doi.org/10.1016/j.pec.2017.02.011

    Article  PubMed  Google Scholar 

  9. Cella D, Choi SW, Condon DM, Schalet B, Hays RD, Rothrock NE, Yount S, Cook KF, Gershon RC, Amtmann D et al (2019) PROMIS((R)) adult health profiles: efficient short-form measures of seven health domains. Value Health 22(5):537–544. https://doi.org/10.1016/j.jval.2019.02.004

    Article  PubMed  PubMed Central  Google Scholar 

  10. Samuel CA, Spencer JC, Rosenstein DL, Reeder-Hayes KE, Manning ML, Sellers JB, Wheeler SB (2020) Racial differences in employment and cost-management behaviors in patients with metastatic breast cancer. Breast Cancer Res Treat 179(1):207–215. https://doi.org/10.1007/s10549-019-05449-9

    Article  CAS  PubMed  Google Scholar 

  11. Wheeler SB, Spencer JC, Manning ML, Samuel CA, Reeder-Hayes KE, Greenup RA, Spees LP, Rosenstein DL (2023) Multidimensional financial hardship among uninsured and insured young adult patients with metastatic breast cancer. Cancer Med 12(10):11930–11940. https://doi.org/10.1002/cam4.5885

    Article  PubMed  PubMed Central  Google Scholar 

  12. Costas-Muniz R, Leng J, Aragones A, Ramirez J, Roberts N, Mujawar MI, Gany F (2016) Association of socioeconomic and practical unmet needs with self-reported nonadherence to cancer treatment appointments in low-income Latino and Black cancer patients. Ethn Health 21(2):118–128. https://doi.org/10.1080/13557858.2015.1034658

    Article  PubMed  Google Scholar 

  13. McDougall JA, Anderson J, Adler Jaffe S, Guest DD, Sussman AL, Meisner ALW, Wiggins CL, Jimenez EY, Pankratz VS (2020) Food insecurity and forgone medical care among cancer survivors. JCO Oncol Pract 16(9):e922–e932. https://doi.org/10.1200/JOP.19.00736

    Article  PubMed  PubMed Central  Google Scholar 

  14. Hastert TA, McDougall JA, Strayhorn SM, Nair M, Beebe-Dimmer JL, Schwartz AG (2021) Social needs and health-related quality of life among African American cancer survivors: results from the Detroit Research on Cancer Survivors study. Cancer 127(3):467–475. https://doi.org/10.1002/cncr.33286

    Article  PubMed  Google Scholar 

  15. Fan Q, Keene DE, Banegas MP, Gehlert S, Gottlieb LM, Yabroff KR, Pollack CE (2022) Housing insecurity among patients with cancer. J Natl Cancer Inst 114(12):1584–1592. https://doi.org/10.1093/jnci/djac136

    Article  PubMed  PubMed Central  Google Scholar 

  16. Graboyes EM, Chaiyachati KH, Sisto Gall J, Johnson W, Krishnan JA, McManus SS, Thompson L, Shulman LN, Yabroff KR (2022) Addressing transportation insecurity among patients with cancer. J Natl Cancer Inst 114(12):1593–1600. https://doi.org/10.1093/jnci/djac134

    Article  PubMed  PubMed Central  Google Scholar 

  17. Raber M, Jackson A, Basen-Engquist K, Bradley C, Chambers S, Gany FM, Halbert CH, Lindau ST, Perez-Escamilla R, Seligman H (2022) Food insecurity among people with cancer: nutritional needs as an essential component of care. J Natl Cancer Inst 114(12):1577–1583. https://doi.org/10.1093/jnci/djac135

    Article  PubMed  PubMed Central  Google Scholar 

  18. Gany FM, Pan S, Ramirez J, Paolantonio L (2020) Development of a medically tailored hospital-based food pantry system. J Health Care Poor Underserved 31(2):595–602. https://doi.org/10.1353/hpu.2020.0047

    Article  PubMed  PubMed Central  Google Scholar 

  19. Chaiyachati KH, Krause D, Sugalski J, Graboyes EM, Shulman LN (2023) A survey of the National Comprehensive Cancer Network on approaches toward addressing patients’ transportation insecurity. J Natl Compr Canc Netw 21(1):21–26. https://doi.org/10.6004/jnccn.2022.7073

    Article  PubMed  PubMed Central  Google Scholar 

  20. Fan Q, Nogueira L, Yabroff KR, Hussaini SMQ, Pollack CE (2022) Housing and cancer care and outcomes: a systematic review. J Natl Cancer Inst 114(12):1601–1618. https://doi.org/10.1093/jnci/djac173

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

We are grateful to the study participants for sharing their experience living with mBC. We also thank Ms. Jacklyn Cho for assistance with development of study materials and WCM IRB protocol submission and Ms. Rumsha Javed for assistance with screening and approaching patients at CUIMC.

Funding

This work was supported by the Conquer Cancer Foundation/Pfizer Global Medical Grants Equitable Care of Metastatic Breast Cancer Patients Award. Dr. Pinheiro received support from the National Cancer Institute (1K01CA251645).

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Authors and Affiliations

  1. Division of Epidemiology, Department of Population Health Sciences, Weill Cornell Medicine, 402 E 67st LA-0005, New York, NY, 10065, USA

    Shoshana M. Rosenberg, Taylor Stein & Laura C. Pinheiro

  2. Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY, USA

    Caroline Zeng, Shakirah N. Ssebyala, Gina Lombardo & Laura C. Pinheiro

  3. Division of Biostatistics, Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA

    Anjile An

  4. Young Survival Coalition, New York, NY, USA

    Desiree Walker

  5. Patient Research Advocate, Ponte Vedra Beach, FL, USA

    Anne Marie Mercurio

  6. Department of Medical Oncology, New York Presbyterian Hospital—Queens Hospital, Queens, NY, USA

    Lauren Elreda

  7. Department of Medical Oncology, Department of Medicine, New York Presbyterian Hospital—Brooklyn Methodist Hospital, Brooklyn, NY, USA

    Evelyn Taiwo

  8. Division of Medical Oncology, Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA

    Dawn L. Hershman

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  1. Shoshana M. Rosenberg
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  12. Laura C. Pinheiro
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Contributions

Conceptualization: SMR and LCP. Project Administration: SMR and LCP. Data collection: CZ, SNS, TS, GL. Data curation: CZ and AA. Formal analysis: AA. Writing—original draft: SMR. Writing—review and editing: All authors.

Corresponding author

Correspondence to Shoshana M. Rosenberg.

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Conflict of interest

The authors have no financial interests to declare.

Ethics approval

The study was approved by the Weill Cornell Medicine and Columbia University Irving Medical Center Institutional Review Boards (IRB). All procedures performed in studies involving human participants were in accordance with the ethical standards of the IRB.

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Informed consent was obtained from all individuals included in the study.

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Rosenberg, S.M., Zeng, C., An, A. et al. Characterizing “collateral damage” in men and women with metastatic breast cancer (mBC) from diverse racial and ethnic backgrounds in New York City. Breast Cancer Res Treat (2024). https://doi.org/10.1007/s10549-024-07347-1

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