Chronically stressful conditions of daily life such as racism, pollution, and poverty have a direct impact on the cellular mechanisms that drive lethal, invasive forms of breast cancer, according to a study led by Duke Cancer Institute researchers.
Published in the journal npj Breast Cancer, the findings provide insight into one of the most pervasive health disparities between White and Black people. Among aggressive subtypes like triple negative and inflammatory breast cancers, Black women have higher incidences and lower survival rates than White women.
Dr. Gayathri Devi, Associate Professor in Surgery, is the senior author on this publication. Devi is also the Director of Duke CTSI’s Duke-NCCU Bridge Office, designed to create opportunities for multidisciplinary collaborations and ensure that faculty, investigators, and trainees at all career levels have access to core resources and services to do innovative research.
“When talking about breast cancer, these disparities are not just in the U.S., but are global,” Devi said. “There is a complex interplay among societal stress factors – access to care, racism, pollution, and the many problems associated with poverty – and the impact these stresses impose at the molecular level inside the body.”
Devi and colleagues, using The Cancer Genome Atlas, identified specific genes from a set of 226 genetic patterns of adaptive stress response that differ depending on the breast cancer subtype. These stress response genes play functional roles in cancer development, including cell life cycles, DNA damage response, signaling pathways, and regulation of cell death-related processes.
The study also associated gene sets known to be involved in cancer signaling and response to oxidative stress with worse breast cancer patient survival outcomes.
“Where race- and/or ancestry-related disparities exist in incidence, treatment, and survival outcomes, identifying the tumor biology has the potential to aid in development of new biomarkers and treatment strategies to mitigate these disparities,” Devi said.