Article Figures & Data
Tables
- Table 1.
Characteristics of NABC patients with breast cancer (N = 4,639), San Francisco Bay Area, 1995 to 2008
Non-Hispanic white African-American Hispanic Asian-American Total n (%) n (%) n (%) n (%) Chi-square P-value n (%) Total patients 1,067 988 1,642 672 4,369 Number of deaths All-cause 277 280 257 92 906 Breast cancer–specific 157 (57) 173 (62) 162 (63) 75 (82) 567 (63) Study <0.01 NC-BCFR high risk 448 (42) 241 (24) 337 (21) 259 (39) 1,285 (29) NC-BCFR sporadic 99 (9) 293 (30) 365 (22) 413 (62) 1,170 (27) SFBCS 520 (49) 454 (46) 940 (57) 0 (0) 1,914 (44) Age at diagnosis (years) <0.01 <30 19 (2) 11 (1) 29 (2) 14 (2) 73 (2) 30–34 79 (7) 32 (3) 69 (4) 48 (7) 228 (5) 35–39 52 (5) 53 (5) 139 (9) 55 (8) 299 (7) 40–44 100 (9) 121 (12) 229 (14) 115 (17) 565 (13) 45–49 153 (14) 162 (16) 297 (18) 127 (19) 739 (17) 50–54 171 (16) 180 (18) 238 (15) 119 (18) 708 (16) 55–59 157 (15) 142 (14) 241 (14) 106 (16) 646 (15) 60–64 149 (14) 152 (15) 193 (12) 88 (13) 582 (13) 65+ 187 (18) 135 (14) 207 (13) 0 (0) 529 (12) AJCC stage <0.01 I 535 (50) 398 (40) 685 (42) 291 (43) 1,909 (44) II 429 (40) 449 (45) 742 (45) 319 (48) 1,939 (44) III 53 (5) 80 (8) 143 (9) 32 (5) 308 (7) IV 17 (2) 25 (3) 24 (2) 13 (2) 79 (2) Unknown 33 (3) 36 (4) 48 (3) 17 (3) 134 (3) Nodal involvement <0.01 No 694 (65) 576 (58) 968 (59) 397 (59) 2,635 (60) Yes 323 (30) 363 (37) 627 (38) 255 (38) 1,568 (36) Unknown 50 (5) 49 (5) 47 (3) 20 (3) 166 (4) Histology 0.19 Ductal 839 (79) 786 (80) 1299 (79) 551 (82) 3,475 (80) Lobular 151 (14) 112 (11) 212 (13) 72 (11) 547 (12) Other 77 (7) 90 (9) 131 (8) 49 (7) 347 (8) Histologic grade <0.01 1 192 (18) 125 (13) 243 (15) 85 (13) 645 (15) 2 423 (40) 314 (32) 592 (36) 278 (41) 1,607 (37) 3 and 4 324 (30) 437 (44) 654 (40) 252 (38) 1,667 (38) Unknown 128 (12) 112 (11) 153 (9) 57 (9) 450 (10) Estrogen and progesterone receptor status <0.01 ER and/or PR negative 160 (15) 261 (26) 378 (23) 127 (19) 926 (21) ER/PR positive 796 (75) 627 (64) 1,122 (68) 476 (71) 3,021 (69) Unknown 111 (10) 100 (10) 142 (9) 69 (10) 422 (10) Surgerya <0.01 None 10 (1) 40 (4) 29 (2) 12 (2) 91 (2) Lumpectomy 581 (55) 592 (60) 899 (55) 317 (47) 2,389 (55) Mastectomy 475 (45) 356 (36) 714 (44) 343 (51) 1,888 (43) Radiation <0.01 No 421 (40) 398 (40) 656 (40) 322 (48) 1,797 (41) Yes 646 (61) 590 (60) 986 (60) 350 (52) 2,572 (59) Chemotherapy <0.01 No 545 (51) 453 (46) 660 (40) 248 (37) 1,906 (44) Yes 505 (47) 519 (53) 968 (59) 417 (62) 2,409 (55) Unknown 17 (2) 16 (2) 14 (1) 7 (1) 54 (1) Education <0.01 <High school 45 (4) 143 (15) 606 (40) 51 (8) 845 (19) High school degree or equivalent 175 (16) 194 (20) 349 (21) 64 (10) 782 (18) Vocational/technical degree or some college 374 (35) 430 (44) 436 (27) 176 (26) 1,416 (32) College degree/graduate school 473 (44) 221 (22) 251 (15) 381 (57) 1,326 (30) Neighborhood (block group) SESb <0.01 Quintile 1-low SES 9 (1) 132 (13) 98 (6) 9 (1) 248 (6) Quintile 2 30 (3) 282 (29) 240 (15) 31 (5) 583 (13) Quintile 3 100 (9) 207 (21) 363 (22) 101 (15) 771 (18) Quintile 4 257 (24) 216 (22) 434 (26) 164 (24) 1,071 (25) Quintile 5-high SES 671 (63) 151 (15) 507 (31) 367 (55) 1,696 (39) % Poverty (block group) <0.01 0–0.049, high SES 627 (59) 202 (20) 591 (36) 350 (52) 1,770 (41) 0.05–0.09 279 (26) 191 (19) 429 (26) 199 (30) 1,098 (25) 0.1–0.19 135 (13) 317 (32) 438 (27) 94 (14) 984 (23) ≥0.2, low SES 26 (2) 278 (28) 184 (11) 29 (4) 517 (12) Marital status <0.01 Single/never married 164 (15) 282 (29) 258 (16) 98 (15) 802 (18) Married 681 (64) 397 (40) 1,018 (62) 522 (78) 2,618 (60) Separated/divorced 114 (11) 197 (20) 207 (12) 34 (5) 552 (13) Widowed 78 (7) 86 (9) 119 (7) 10 (2) 293 (7) Unknown 30 (3) 26 (3) 40 (2) 8 (1) 104 (2) History of benign breast disease <0.01 No 817 (77) 794 (80) 1,405 (86) 576 (86) 3,592 (82) Yes 250 (23) 192 (19) 234 (14) 96 (14) 772 (18) Unknown 0 (0) 2 (0) 3 (0) 0 (0) 5 (0) Years since last full-term pregnancy <0.01 Nulliparous 272 (26) 180 (18) 234 (14) 173 (26) 859 (20) <2 25 (2) 14 (1) 21 (1) 17 (3) 77 (2) 2–4 40 (4) 26 (3) 82 (5) 47 (7) 195 (5) 5+ 726 (68) 767 (78) 1,303 (79) 435 (65) 3,231 (74) Unknown 4 (0) 1 (0) 2 (0) 0 (0) 7 (0) History of oral contraceptive use <0.01 No 285 (27) 271 (27) 535 (33) 365 (54) 1,456 (33) Yes 730 (68) 679 (69) 1,052 (64) 306 (46) 2,767 (63) Unknown 52 (5) 38 (4) 55 (3) 1 (0) 146 (3) History of menopausal hormone therapy usec <0.01 No 540 (51) 686 (70) 1,126 (69) 514 (77) 2,866 (66) Past 197 (19) 201 (20) 232 (14) 90 (13) 720 (17) Recent 330 (31) 101 (10) 284 (17) 68 (10) 783 (18) Alcohol consumption (g/day) in the year before diagnosis <0.01 0 380 (36) 614 (62) 1,045 (64) 617 (92) 2,656 (61) <5 240 (23) 125 (13) 263 (16) 21 (3) 649 (15) 5–9 135 (13) 97 (10) 107 (7) 12 (2) 351 (8) 10–14 109 (10) 48 (5) 99 (6) 9 (1) 265 (6) ≥15 196 (18) 101 (10) 124 (8) 10 (2) 431 (10) Unknown 7 (1) 3 (0) 4 (0) 3 (0) 17 (0) BMI (kg/m2) in year before diagnosis <0.01 <25.0 604 (57) 262 (27) 529 (32) 471 (70) 1,866 (43) 25.0–29.9 257 (24) 312 (32) 543 (33) 146 (22) 1,258 (29) ≥30.0 197 (19) 400 (41) 549 (33) 48 (7) 1,194 (27) Unknown 9 (1) 14 (1) 21 (1) 7 (1) 51 (1) Recent recreational physical activity (hours/week) <0.01 0, None 260 (24) 288 (29) 686 (42) 211 (31) 1,445 (33) Quartiles 1 & 2 330 (31) 460 (47) 476 (29) 241 (36) 1,507 (35) Quartile 3 & 4 476 (45) 240 (24) 479 (29) 218 (32) 1,413 (32) Unknown 1 (0) 0 (0) 1 (0) 2 (0) 4 (0) Percent of race/ethnic-concordant patients with cancer in reporting hospital (%) <0.01 <25 1 (0) 646 (65) 1456 (89) 562 (84) 2,665 (61) 25–49 70 (7) 342 (35) 186 (11) 86 (13) 684 (16) 50–74 472 (44) 0 (0) 0 (0) 10 (2) 482 (11) ≥75 524 (49) 0 (0) 0 (0) 14 (2) 538 (12) Percent of patients with cancer in highest SES quintile in reporting hospital (%) <0.01 <25 169 (16) 317 (32) 420 (26) 124 (19) 1,030 (24) 25–49 286 (27) 491 (50) 492 (30) 249 (37) 1,518 (35) 50–74 521 (49) 163 (17) 659 (40) 251 (37) 1,594 (37) ≥75 91 (9) 17 (2) 71 (4) 48 (7) 227 (5) - Table 2.
Distributions of education and neighborhood SES by race/ethnicity for NABC patients with breast cancer, San Francisco Bay Area, 1995 to 2008
Education <High school graduation High school graduation Vocational school/some college College+ Totala Neighborhood SESb N (%) N (%) N (%) N (%) N (%) Non-Hispanic white Neighborhood SES Q1-low SES 1 (11.1) 3 (33.3) 3 (33.3) 2 (22.2) 9 (0.8) Q2 3 (10.0) 8 (26.7) 14 (46.7) 5 (16.7) 30 (2.8) Q3 12 (12.0) 24 (24.0) 41 (41.0) 23 (23.0) 100 (9.4) Q4 21 (8.1) 52 (20.2) 86 (33.3) 98 (38.0) 258 (24.2) Q5-high SES 8 (1.2) 88 (13.1) 230 (34.3) 345 (51.4) 671 (62.8) Total 45 (4.2) 175 (16.4) 374 (35.0) 473 (44.3) 1,068 (100.0) African-American Neighborhood SES Q1-low SES 38 (28.6) 34 (25.6) 51 (38.3) 9 (6.8) 133 (13.4) Q2 55 (19.4) 59 (20.8) 133 (46.8) 35 (12.3) 284 (28.6) Q3 23 (11.0) 46 (22.0) 93 (44.5) 45 (21.5) 209 (21.0) Q4 19 (8.8) 39 (18.1) 103 (47.7) 55 (25.5) 216 (21.8) Q5-high SES 8 (5.3) 16 (10.6) 50 (33.1) 77 (51.0) 151 (15.2) Total 143 (14.4) 194 (19.5) 430 (43.3) 221 (22.3) 993 (100.0) Hispanic Neighborhood SES Q1-low SES 64 (64.6) 13 (13.1) 16 (16.2) 5 (5.1) 99 (5.9) Q2 146 (58.9) 42 (16.9) 41 (16.5) 11 (4.4) 248 (14.9) Q3 184 (49.2) 75 (20.1) 75 (20.1) 29 (7.8) 374 (22.4) Q4 123 (28.0) 115 (26.1) 126 (28.6) 70 (15.9) 440 (26.3) Q5-high SES 89 (17.5) 104 (20.4) 178 (35.0) 136 (26.7) 509 (30.5) Total 606 (36.3) 349 (20.9) 436 (26.1) 251 (15.0) 1,670 (100.0) Asian-American Neighborhood SES Q1-low SES 3 (33.3) 2 (22.2) 1 (11.1) 3 (33.3) 9 (1.3) Q2 7 (22.6) 8 (25.8) 8 (25.8) 8 (25.8) 31 (4.6) Q3 14 (13.9) 16 (15.8) 22 (21.8) 49 (48.5) 101 (15.0) Q4 14 (8.5) 19 (11.6) 57 (34.8) 74 (45.1) 164 (24.3) Q5-high SES 13 (3.5) 19 (5.1) 88 (23.8) 247 (66.9) 369 (54.7) Total 51 (7.6) 64 (9.5) 176 (26.1) 381 (56.5) 674 (100.0) -
↵aTotals include patients with unknown education, and therefore row numbers may not add up to the total. Note that those with unknown education were excluded from the analytic sample.
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↵bNeighborhood SES was measured using a composite measure of 7 Census indicator measures known as the YOST SES Index (29).
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- Table 3.
Association of individual and neighborhood SES with all-cause mortality by race/ethnicity: HRs with 95% CIs, San Francisco Bay Area, 1995 to 2008 (with follow-up through 2009)
Non-Hispanic white African-American Hispanic Asian-American Base modela Base + education + nSES modelb Base modela Base + education + nSES modelb Base modela Base + education + nSES modelb Base modela Base + education + nSES modelb SES variables HR (95% CI) HR (95% CI) HR (95% CI) HR (95% CI) HR (95% CI) HR (95% CI) HR (95% CI) HR (95% CI) Education College degree+ 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) Vocational/some college 1.03 (0.78–1.36) 1.01 (0.76–1.34) 0.92 (0.65–1.31) 0.88 (0.62–1.26) 1.31 (0.83–2.06) 1.25 (0.79–1.97) 1.29 (0.74–2.23) 1.11 (0.63–1.97) = High school degreec 1.27 (0.92–1.74) 1.19 (0.86–1.65) 1.03 (0.69–1.54) 0.92 (0.60–1.40) 1.20 (0.75–1. 92) 1.08 (0.66–1.77) 2.13 (1.28–3.52) 1.53 (0.89–2.62) <High school degree 1.40 (0.96–2.06) 1.20 (0.80–1.80) 1.38 (0.90–2.11) 1.15 (0.73–1.81) Ptrend 0.17 0.34 0.05 0.31 0.19 0.76 0.01 0.13 Neighborhood SES (nSES)e Q5-high SES 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) Q4 1.15 (0.86–1.54) 1.12 (0.84–1.50) 0.65 (0.41–1.02) 0.66 (0.42–1.03) 1.12 (0.77–1.63) 1.12 (0.76–1.64) 2.14 (1.31–3.51) 1.99 (1.19–3.34) Q3 1.28 (0.86–1.91) 1.24 (0.83–1.85) 1.03 (0.67–1.59) 1.03 (0.66–1.61) 1.38 (0.96–1.99) 1.37 (0.92–2.02) 2.29 (1.24–4.23) 2.02 (1.07–3.82) Q2d 1.64 (0.91–2.94) 1.56 (0.86–2.83) 1.17 (0.80–1.71) 1.16 (0.78–1.71) 1.59 (1.07–2.36) 1.57 (1.03–2.38) 3.79 (1.89–7.61) 3.18 (1.51–6.70) Q1-low SES 1.33 (0.86–2.05) 1.29 (0.82–2.03) 1.59 (0.94–2.67) 1.57 (0.92–2.71) Ptrend 0.05 0.08 0.01 0.03 0.01 0.01 0.01 0.01 Education and nSESf ≥Some college, high nSES 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) ≥Some college, low nSES 1.22 (0.78–1.91) 1.61 (1.16–2.25) 1.41 (0.89–2.23) 1.89 (1.02–3.50) ≤HS degree, high nSES 1.19 (0.86–1.63) 1.44 (0.86–2.42) 0.99 (0.70–1.41) 1.84 (1.00–3.38) ≤HS degree, low nSES 1.62 (1.02–2.56) 1.67 (1.20–2.32) 1.39 (1.01–1.92) 2.68 (1.37–5.23) NOTE: Bold font refers to statistically significant associations.
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↵aAdjusted for age at diagnosis (continuous), year of diagnosis (continuous), study eligibility [Northern California site of the Breast Cancer Family Registry (NC-BCFR) high risk, NC-BCFR sporadic, SFBCS], nodal involvement (no, yes, unknown), histology (ductal, lobular, other), histologic grade (1–4, unknown), joint ERPR status (ER−PR−, ER+, or PR+, unknown), type of surgery (none, lumpectomy, mastectomy, not otherwise specified, unknown), radiation (no, yes, unknown), chemotherapy (no, yes, unknown), subsequent primary tumor (yes, no) and clustering by block group, and stratified by AJCC stage (I–IV, unknown).
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↵bAdjusted for covariates of model 1 and clustering by block group (individual education and neighborhood SES in the same model), and stratified by AJCC stage (I–IV, unknown).
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↵cEducation levels <high school graduate and high school graduate collapsed as for non-Hispanic whites and Asian-Americans because of small sample sizes.
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↵dNeighborhood SES quintiles 1 and 2 were collapsed for non-Hispanic whites and Asian-Americans because of small sample sizes.
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↵eNeighborhood SES was measured using a composite measure of 7 Census indicator measures known as the YOST SES Index (29).
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↵fHS, high school. Education levels (<high school graduate and high school graduate) collapsed as ≤ high school graduate. Neighborhood SES levels collapsed as Q1 to Q3: low SES; Q4 to Q5: high SES.
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- Table 4.
Association of individual and neighborhood SES with all-cause mortality adjusted for reproductive factors, marital status, behavioral factors, and hospital characteristics, by race/ethnicity: HRs with 95% CIs, San Francisco Bay Area, 1995 to 2008 (with follow-up through 2009)
All-cause mortality Cases Deaths Base + SES + reproductive factor modela Base + SES + marital status modelb Base + SES + behavioral factors modelc Base + SES + hospital characteristics modeld SES variables n (%) n (%) HR (95% CI) HR (95% CI) HR (95% CI) HR (95% CI) Non-Hispanic whites Education College+ 473 (44.3%) 112 (40.4%) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) Vocational/some college 374 (35.1%) 95 (34.3%) 1.01 (0.76–1.34) 1.01 (0.76–1.34) 0.96 (0.72–1.28) 1.05 (0.78–1.40) ≤High school graduatee 220 (20.6%) 70 (25.3%) 1.18 (0.85–1.63) 1.23 (0.89–1.69) 1.09 (0.78–1.53) 1.25 (0.90–1.73) Ptrend 0.37 0.26 0.66 0.21 Neighborhood SES (nSES)f Q5-high SES 671 (62.9%) 161 (58.1%) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) Q4 257 (24.1%) 70 (25.3%) 1.11 (0.82–1.50) 1.09 (0.81–1.47) 1.08 (0.80–1.45) 1.09 (0.81–1.46) Q3 100 (9.4%) 32 (11.6%) 1.24 (0.83–1.85) 1.18 (0.78–1.77) 1.17 (0.78–1.79) 1.18 (0.78–1.79) Q1, Q2-low SES 39 (3.7%) 14 (5.1%) 1.49 (0.82–2.72) 1.51 (0.84–2.72) 1.51 (0.81–2.80) 1.48 (0.79–2.76) Ptrend 0.12 0.15 0.17 0.18 Education and nSESg ≥ College, high nSES 759 (71.1%) 180 (65.0%) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) ≥ College, low nSES 88 (8.3%) 27 (9.8%) 1.19 (0.76–1.86) 1.18 (0.75–1.85) 1.18 (0.76–1.85) 1.17 (0.73–1.85) ≤ High school graduate, high nSES 169 (15.8%) 51 (18.4%) 1.16 (0.83–1.61) 1.21 (0.88–1.66) 1.12 (0.81–1.55) 1.20 (0.88–1.65) ≤ High school graduate, low nSES 51 (4.8%) 19 (6.9%) 1.62 (1.03–2.54) 1.59 (1.01–2.51) 1.44 (0.90–2.28) 1.60 (0.99–2.60) African-Americans Education (N = 980) (N = 280) College+ 221 (22.4%) 49 (17.5%) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) Vocational/some college 430 (43.5%) 112 (40.0%) 0.90 (0.62–1.31) 0.89 (0.62–1.29) 0.86 (0.60–1.25) 0.91 (0.63–1.31) High school graduate 194 (19.6%) 59 (21.1%) 0.91 (0.58–1.41) 0.94 (0.62–1.44) 0.87 (0.56–1.35) 0.97 (0.63–1.50) <High school graduate 143 (14.5%) 60 (21.4%) 1.18 (0.78–1.80) 1.24 (0.82–1.88) 1.17 (0.77–1.77) 1.26 (0.83–1.90) Ptrend 0.38 0.24 0.40 0.20 Neighborhood SES (nSES)f Q5-high SES 151 (15.3%) 42 (15.0%) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) Q4 216 (21.9%) 46 (16.4%) 0.67 (0.42–1.05) 0.64 (0.41–1.01) 0.68 (0.43–1.08) 0.65 (0.41–1.03) Q3 207 (21.0%) 54 (19.3%) 0.99 (0.62–1.59) 1.02 (0.64–1.61) 0.98 (0.63–1.55) 1.04 (0.65–1.66) Q2 282 (28.5%) 88 (31.4%) 1.11 (0.75–1.66) 1.14 (0.77–1.69) 1.16 (0.78–1.72) 1.09 (0.72–1.66) Q1-low SES 132 (13.4%) 50 (17.9%) 1.26 (0.79–2.01) 1.29 (0.81–2.03) 1.29 (0.81–2.04) 1.19 (0.73–1.92) Ptrend 0.04 0.02 0.03 0.06 Education and nSESg ≥ College, high nSES 285 (28.9%) 61 (21.8%) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) ≥ College, low nSES 366 (37.0%) 100 (35.7%) 1.62 (1.15–2.27) 1.62 (1.15–2.27) 1.57 (1.12–2.20) 1.58 (1.12–2.22) ≤ High school graduate, high nSES 82 (8.3%) 27 (9.6%) 1.53 (0.91–2.57) 1.44 (0.86–2.42) 1.44 (0.85–2.42) 1.46 (0.87–2.47) ≤ High school graduate, low nSES 255 (25.8%) 92 (32.9%) 1.58 (1.11–2.23) 1.70 (1.22–2.36) 1.58 (1.13–2.22) 1.68 (1.20–2.35) Hispanics Education (N = 1,642) (N = 257) College+ 251 (15.3%) 29 (11.3%) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) Vocational/some college 436 (26.6%) 58 (22.6%) 1.20 (0.75–1.89) 1.24 (0.78–1.97) 1.24 (0.78–1.95) 1.23 (0.78–1.94) High school graduate 349 (21.3%) 50 (19.5%) 1.06 (0.64–1.74) 1.11 (0.67–1.83) 1.06 (0.64–1.74) 1.07 (0.65–1.75) <High school graduate 606 (36.9%) 120 (46.7%) 1.04 (0.65–1.64) 1.17 (0.74–1.86) 1.06 (0.66–1.71) 1.06 (0.67–1.68) Ptrend 0.79 0.72 0.82 0.85 Neighborhood SES (nSES)f Q5-high SES 507 (30.9%) 67 (26.1%) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) Q4 434 (26.4%) 65 (25.3%) 1.14 (0.77–1.67) 1.13 (0.77–1.66) 1.08 (0.74–1.59) 1.07 (0.73–1.57) Q3 363 (22.1%) 62 (24.1%) 1.33 (0.89–1.97) 1.35 (0.91–2.00) 1.29 (0.86–1.92) 1.27 (0.86–1.88) Q2 240 (14.6%) 48 (18.7%) 1.65 (1.08–2.50) 1.61 (1.07–2.43) 1.50 (0.99–2.27) 1.41 (0.91–2.17) Q1-low SES 98 (6.0%) 15 (5.8%) 1.51 (0.87–2.61) 1.65 (0.97–2.82) 1.55 (0.91–2.64) 1.36 (0.78–2.39) Ptrend 0.01 <0.01 0.02 0.08 Education and nSESg ≥ College, high nSES 510 (31.1%) 64 (24.9%) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) ≥ College, low nSES 177 (10.8%) 23 (9.0%) 1.34 (0.86–2.10) 1.40 (0.89–2.23) 1.34 (0.84–2.13) 1.26 (0.79–2.03) ≤ High school graduate, high nSES 431 (26.3%) 68 (26.5%) 0.94 (0.65–1.35) 1.02 (0.71–1.45) 0.93 (0.64–1.34) 0.93 (0.65–1.33) ≤ High school graduate, low nSES 524 (31.9%) 102 (39.7%) 1.29 (0.93–1.80) 1.43 (1.04–1.98) 1.25 (0.87–1.78) 1.20 (0.85–1.71) Asian-Americans Education (N = 672) (N = 92) College+ 381 (56.7%) 41 (44.6%) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) Vocational/some college 176 (26.2%) 24 (26.1%) 1.19 (0.66–2.15) 1.18 (0.65–2.15) 1.03 (0.58–1.85) 1.08 (0.61–1.90) ≤ High school graduatee 115 (17.1%) 27 (29.4%) 1.45 (0.83–2.53) 1.57 (0.90–2.73) 1.31 (0.69–2.47) 1.46 (0.84–2.53) Ptrend 0.20 0.12 0.45 0.21 Neighborhood SES (nSES)f Q5-high SES 367 (54.6%) 38 (41.3%) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) Q4 164 (24.4%) 27 (29.4%) 1.85 (1.09–3.11) 1.91 (1.13–3.23) 2.01 (1.17–3.47) 1.93 (1.15–3.25) Q3 101 (15.0%) 18 (19.6%) 1.79 (0.91–3.54) 1.93 (1.00–3.69) 1.89 (1.00–3.54) 1.86 (0.95–3.62) Q1, Q2-low SES 40 (6.0%) 9 (9.8%) 3.20 (1.52–6.73) 2.68 (1.17–6.13) 3.11 (1.42–6.78) 3.05 (1.39–6.70) Ptrend <0.01 <0.01 <0.01 <0.01 Education and nSESg ≥College, high nSES 466 (69.4%) 50 (54.4%) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) ≥College, low nSES 91 (13.5%) 15 (16.3%) 1.85 (0.99–3.47) 1.72 (0.91–3.27) 1.78 (0.96–3.29) 1.62 (0.80–3.27) ≤High school graduate, high nSES 65 (9.7%) 15 (16.3%) 1.79 (0.94–3.42) 1.82 (0.97–3.40) 1.67 (0.82–3.43) 1.64 (0.88–3.05) ≤High school graduate, low nSES 50 (7.4%) 12 (13.0%) 2.32 (1.13–4.78) 2.54 (1.26–5.10) 2.21 (1.06–4.60) 2.43 (1.20–4.92) NOTE: Bold font refers to statistically significant associations.
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↵aAdjusted for age at diagnosis (continuous), year of diagnosis (continuous), study eligibility (NC-BCFR high risk, NC-BCFR sporadic, SFBCS), histology (ductal, lobular, other), histologic grade (1–4, unknown), joint ERPR status (ER−PR−, ER+, or PR+, unknown), nodal involvement (none, positive, unknown), type of surgery (none, lumpectomy, mastectomy, NOS, unknown), radiation (no, yes, unknown), chemotherapy (no, yes, unknown), first subsequent primary tumor (yes, no), second subsequent primary tumor (yes, no), days between the dates of diagnosis of study qualifying tumor and the first subsequent tumor (continuous), days between the dates of diagnosis of the first and second subsequent tumor (continuous), benign breast disease (no, yes, unknown), years since last full-term pregnancy (≤2, 2–4, 5±, unknown), prediagnosis hormonal contraception use (never, ever, unknown), prediagnosis hormone therapy use (never, past, recent, unknown) and clustering by block group, and stratified by AJCC stage (I– IV, unknown).
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↵bAdjusted for age at diagnosis (continuous), study eligibility (NC-BCFR high risk, NC-BCFR sporadic, SFBCS), histology (ductal, lobular, other), histologic grade (1–4, unknown), joint ERPR status (ER−PR−, ER+, or PR+, unknown), nodal involvement (none, positive, unknown), type of surgery (none, lumpectomy, mastectomy, NOS, unknown), radiation (no, yes, unknown), chemotherapy (no, yes, unknown), first subsequent primary tumor (yes, no), second subsequent primary tumor (yes, no), days between the dates of diagnosis of study qualifying tumor and the first subsequent tumor (continuous), days between the dates of diagnosis of the first and second subsequent tumor (continuous), marital status (single/never married, married, separated/divorced, widowed, unknown) and clustering by block group, and stratified by AJCC stage (I–IV, unknown).
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↵cAdjusted for age at diagnosis (continuous), study eligibility (NC-BCFR high risk, NC-BCFR sporadic, SFBCS), histology (ductal, lobular, other), histologic grade (1–4, unknown), joint ERPR status (ER−PR−, ER+, or PR+, unknown), nodal involvement (none, positive, unknown), type of surgery (none, lumpectomy, mastectomy, NOS, unknown), radiation (no, yes, unknown), chemotherapy (no, yes, unknown), first subsequent primary tumor (yes, no), second subsequent primary tumor (yes, no), days between the dates of diagnosis of study qualifying tumor and the first subsequent tumor (continuous), days between the dates of diagnosis of the first and second subsequent tumor (continuous), grams per day of alcohol in reference year (0, ≤5, 5–9, 10–14, 15±, unknown), prediagnosis BMI (≤25, 25–29, 30±, unknown), recent recreational physical activity (0, Q1/Q2, Q3/Q4, unknown) and clustering by block group, and stratified by AJCC stage (I–IV, unknown).
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↵dAdjusted for age at diagnosis (continuous), study eligibility (NC-BCFR high risk, NC-BCFR sporadic, SFBCS), histology (ductal, lobular, other), histologic grade (1–4, unknown), joint ERPR status (ER−PR−, ER+, or PR+, unknown), nodal involvement (none, positive, unknown), type of surgery (none, lumpectomy, mastectomy, NOS, unknown), radiation (no, yes, unknown), chemotherapy (no, yes, unknown), first subsequent primary tumor (yes, no), second subsequent primary tumor (yes, no), days between the dates of diagnosis of study qualifying tumor and the first subsequent tumor (continuous), days between the dates of diagnosis of the first and second subsequent tumor (continuous), percent of white patients with cancer in reporting hospital (≤25%, 25–49%, 50–74%, ≥75%, unknown), percent of patients with cancer in highest SES quintile in reporting hospital (≤25%, 25–49%, 50–74%, ≥75%, unknown) and clustering by block group, and stratified by AJCC stage (I–IV, unknown).
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↵eEducation levels (<high school graduate and high school graduate) collapsed as ≤ high school graduate.
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↵fNeighborhood SES was measured using a composite measure of 7 Census indicator measures known as the Yost SES Index (29).
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↵gSES levels collapsed as Q1 to Q3: low SES; Q4 to Q5: high SES.
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- Table 5.
Association of individual and neighborhood SES with breast cancer–specific mortality by race/ethnicity: HRs with 95% CIs, San Francisco Bay Area, 1995 to 2008 (with follow-up through 2009)
Non-Hispanic white African-American Hispanic Asian-American Base modela Base + education + SES modelb Base modela Base + education + SES modelb Base modela Base + education + SES modelb Base modela Base + education + SES modelb SES variables HR (95% CI) HR (95% CI) HR (95% CI) HR (95% CI) HR (95% CI) HR (95% CI) HR (95% CI) HR (95% CI) Education College degree+ 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) Vocational/some college 0.87 (0.59–1.29) 0.87 (0.59–1.29) 0.74 (0.49–1.14) 0.70 (0.45–1.09) 1.41 (0.83–2.37) 1.36 (0.80–2.32) 1.11 (0.59–2.09) 0.93 (0.49–1.76) = High school degreec 1.15 (0.75–1.77) 1.14 (0.73–1.77) 0.65 (0.39–1.10) 0.56 (0.32–1.00) 1.17 (0.66–2.08) 1.09 (0.60–2.00) 1.93 (1.09–3.43) 1.23 (0.66–2.31) <High school degree 0.97 (0.59–1.60) 0.83 (0.49–1.40) 1.37 (0.82–2.27) 1.22 (0.70–2.13) Ptrend 0.70 0.74 0.61 0.31 0.43 0.86 0.04 0.51 Neighborhood SESe Q5-high SES 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) Q4 1.12 (0.76–1.65) 1.09 (0.73–1.62) 0.63 (0.37–1.09) 0.67 (0.39–1.15) 0.85 (0.54–1.35) 0.84 (0.53–1.36) 2.63 (1.51–4.60) 2.55 (1.42–4.58) Q3 1.02 (0.61–1.70) 1.00 (0.59–1.68) 0.78 (0.45–1.37) 0.88 (0.50–1.57) 1.05 (0.67–1.66) 1.03 (0.63–1.69) 2.97 (1.47–5.98) 2.78 (1.36–5.71) Q2d 1.08 (0.41–2.87) 1.05 (0.40–2.75) 0.95 (0.60–1.52) 1.08 (0.67–1.74) 1.41 (0.87–2.30) 1.38 (0.83–2.30) 4.25 (1.99–9.08) 3.91 (1.72–8.91) Q1-low SES 1.20 (0.71–2.02) 1.42 (0.81–2.47) 1.48 (0.78–2.84) 1.47 (0.74–2.91) Ptrend 0.75 0.80 0.17 0.10 0.10 0.14 0.01 0.01 Education and nSESf ≥Some college, high nSES 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) ≥Some college, low nSES 0.78 (0.41–1.50) 1.45 (0.99–2.14) 1.08 (0.59–1.97) 2.26 (1.14–4.49) ≤HS degree, high nSES 1.09 (0.69–1.73) 1.25 (0.65–2.43) 0.84 (0.52–1.34) 1.74 (0.88–3.44) ≤HS degree, low nSES 1.52 (0.82–2.82) 1.11 (0.72–1.70) 1.24 (0.83–1.86) 2.82 (1.29–6.14) NOTE: Bold font refers to statistically significant associations.
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↵aAdjusted for age at diagnosis (continuous), year of diagnosis (continuous), study eligibility (FRBC high risk, case–control, FRBC sporadic), nodal involvement (no, yes, unknown), histology (ductal, lobular, other), histologic grade (1–4, unknown), joint ERPR status (ER−PR−, ER+, or PR+, unknown), type of surgery (none, lumpectomy, mastectomy, NOS, unknown), radiation (no, yes, unknown), chemotherapy (no, yes, unknown), subsequent primary tumor (yes, no) and clustering by block group, and stratified by AJCC stage (I–IV, unknown).
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↵bAdjusted for covariates of model 1 and clustering by block group (individual education and neighborhood SES in the same model), and stratified by AJCC stage (I–IV, unknown).
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↵cEducation levels (<high school graduate and high school graduate) collapsed as ≤ high school graduate for non-Hispanic whites and Asian-Americans because of small sample sizes.
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↵dNeighborhood SES quintiles 1 and 2 were collapsed for non-Hispanic whites and Asian-Americans because of small sample sizes.
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↵eNeighborhood SES was measured using a composite measure of 7 Census indicator measures known as the YOST SES Index (29).
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↵fHS, high school. Education levels (<high school graduate and high school graduate) collapsed as ≤ high school graduate. Neighborhood SES levels collapsed as Q1 to Q3: low SES; Q4 to Q5: high SES.
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- Table 6.
Association of individual and neighborhood SES with breast cancer–specific mortality adjusted for reproductive factors, marital status, behavioral factors, and hospital characteristics, by race/ethnicity: HRs with 95% CIs, San Francisco Bay Area, 1995 to 2008 (with follow-up through 2009)
Breast cancer mortality Cases Deaths Base + SES + reproductive factor modela Base + SES + marital status modelb Base + SES + behavioral factors modelc Base + SES + hospital characteristics modeld SES variables n (%) n (%) HR (95% CI) HR (95% CI) HR (95% CI) HR (95% CI) Non-Hispanic whites Education (N = 1,067) (N = 157) College+ 473 (44.3%) 74 (47.1%) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) Vocational/some college 374 (35.1%) 49 (31.2%) 0.89 (0.60–1.31) 0.90 (0.61–1.33) 0.89 (0.59–1.33) 0.91 (0.60–1.38) ≤ High school graduatee 220 (20.6%) 34 (21.7%) 1.13 (0.72–1.76) 1.17 (0.76–1.82) 1.12 (0.71–1.76) 1.16 (0.74–1.82) Ptrend 0.75 0.63 0.76 0.64 Neighborhood SES (nSES)f Q5-high SES 671 (62.9%) 93 (59.2%) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) Q4 257 (24.1%) 42 (26.8%) 1.07 (0.71–1.60) 1.06 (0.71–1.60) 1.07 (0.71–1.61) 0.97 (0.64–1.46) Q3 100 (9.4%) 16 (10.2%) 0.95 (0.55–1.64) 0.91 (0.53–1.58) 0.94 (0.56–1.57) 0.81 (0.46–1.43) Q1, Q2-low SES 39 (3.7%) 6 (3.8%) 1.01 (0.38–2.70) 1.02 (0.40–2.61) 1.12 (0.44–2.86) 0.84 (0.30–2.34) Ptrend 1.00 0.94 0.92 0.52 Education and nSESg ≥ College, high nSES 759 (71.1%) 111 (70.7%) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) ≥ College, low nSES 88 (8.3%) 12 (7.6%) 0.74 (0.38–1.43) 0.74 (0.39–1.42) 0.78 (0.41–1.46) 0.64 (0.33–1.27) ≤ High school graduate, high nSES 169 (15.8%) 24 (15.3%) 1.06 (0.66–1.69) 1.11 (0.71–1.76) 1.07 (0.67–1.72) 1.06 (0.67–1.68) ≤ High school graduate, low nSES 51 (4.8%) 10 (6.4%) 1.48 (0.80–2.75) 1.43 (0.75–2.70) 1.44 (0.78–2.68) 1.33 (0.69–2.53) African-Americans Education (N = 980) (N = 173) College+ 221 (22.4%) 38 (22.0%) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) Vocational/some college 430 (43.5%) 78 (45.1%) 0.67 (0.42–1.07) 0.70 (0.45–1.10) 0.68 (0.42–1.08) 0.72 (0.46–1.13) High school graduate 194 (19.6%) 31 (17.9%) 0.52 (0.29–0.95) 0.58 (0.33–1.03) 0.55 (0.30–1.00) 0.58 (0.33–1.04) <High school graduate 143 (14.5%) 26 (15.0%) 0.79 (0.46–1.36) 0.92 (0.53–1.58) 0.84 (0.49–1.45) 0.87 (0.51–1.46) Ptrend 0.25 0.48 0.36 0.39 Neighborhood SES (nSES)f Q5-high SES 151 (15.3%) 29 (16.8%) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) Q4 216 (21.9%) 33 (19.1%) 0.69 (0.40–1.20) 0.68 (0.39–1.18) 0.67 (0.39–1.16) 0.66 (0.38–1.14) Q3 207 (21.0%) 29 (16.8%) 0.85 (0.47–1.56) 0.91 (0.50–1.67) 0.81 (0.45–1.45) 0.89 (0.50–1.58) Q2 282 (28.5%) 53 (30.6%) 1.11 (0.68–1.81) 1.12 (0.68–1.83) 1.02 (0.62–1.67) 1.04 (0.63–1.72) Q1-low SES 132 (13.4%) 29 (16.8%) 1.45 (0.82–2.54) 1.50 (0.85–2.62) 1.36 (0.78–2.37) 1.34 (0.75–2.40) Ptrend 0.05 0.04 0.10 0.09 Education and nSESg ≥ College, high nSES 285 (28.9%) 46 (26.6%) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) ≥ College, low nSES 366 (37.0%) 70 (40.5%) 1.48 (0.99–2.21) 1.48 (1.00–2.20) 1.40 (0.94–2.09) 1.45 (0.97–2.15) ≤ High school graduate, high nSES 82 (8.3%) 16 (9.3%) 1.30 (0.67–2.54) 1.23 (0.63–2.41) 1.36 (0.70–2.65) 1.27 (0.65–2.46) ≤ High school graduate, low nSES 255 (25.8%) 41 (23.7%) 1.05 (0.66–1.65) 1.18 (0.76–1.83) 1.07 (0.70–1.64) 1.12 (0.73–1.73) Hispanics Education (N = 1,642) (N = 162) College+ 251 (15.3%) 20 (12.4%) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) Vocational/some college 436 (26.6%) 42 (25.9%) 1.29 (0.76–2.21) 1.34 (0.79–2.29) 1.35 (0.78–2.31) 1.31 (0.77–2.23) High school graduate 349 (21.3%) 32 (19.8%) 1.07 (0.58–1.98) 1.09 (0.59–2.01) 1.12 (0.61–2.06) 1.05 (0.57–1.92) <High school graduate 606 (36.9%) 68 (42.0%) 1.10 (0.62–1.97) 1.23 (0.70–2.15) 1.23 (0.68–2.24) 1.08 (0.61–1.91) Ptrend 0.93 0.76 0.78 0.82 Neighborhood SES (nSES)f Q5-high SES 507 (30.9%) 47 (29.0%) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) Q4 434 (26.4%) 39 (24.1%) 0.86 (0.53–1.41) 0.84 (0.52–1.35) 0.86 (0.53–1.41) 0.82 (0.51–1.33) Q3 363 (22.1%) 36 (22.2%) 1.07 (0.64–1.78) 1.02 (0.62–1.67) 1.02 (0.60–1.71) 0.93 (0.57–1.52) Q2 240 (14.6%) 30 (18.5%) 1.48 (0.88–2.48) 1.43 (0.86–2.37) 1.38 (0.82–2.33) 1.20 (0.70–2.08) Q1-low SES 98 (6.0%) 10 (6.2%) 1.53 (0.77–3.02) 1.50 (0.76–2.97) 1.56 (0.79–3.09) 1.14 (0.57–2.28) Ptrend 0.09 0.11 0.13 0.47 Education and nSESg ≥ College, high nSES 510 (31.1%) 48 (29.6%) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) ≥ College, low nSES 177 (10.8%) 14 (8.6%) 1.05 (0.58–1.89) 1.09 (0.60–1.98) 1.08 (0.58–2.02) 0.93 (0.50–1.73) ≤ High school graduate, high nSES 431 (26.3%) 38 (23.5%) 0.78 (0.48–1.28) 0.85 (0.53–1.37) 0.86 (0.53–1.41) 0.77 (0.48–1.25) ≤ High school graduate, low nSES 524 (31.9%) 62 (38.3%) 1.23 (0.81–1.87) 1.27 (0.85–1.89) 1.26 (0.80–1.97) 1.01 (0.65–1.55) Asian-Americans Education (N = 672) (N = 75) College+ 381 (56.7%) 35 (46.7%) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) Vocational/some college 176 (26.2%) 18 (24.0%) 1.00 (0.51–1.94) 1.01 (0.52–1.98) 0.86 (0.45–1.64) 0.90 (0.48–1.68) ≤ High school graduatee 115 (17.1%) 22 (29.3%) 1.14 (0.59–2.20) 1.31 (0.69–2.48) 0.98 (0.47–2.03) 1.13 (0.59–2.15) Ptrend 0.71 0.46 0.87 0.80 Neighborhood SES (nSES)f Q5-high SES 367 (54.6%) 29 (38.7%) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) Q4 164 (24.4%) 22 (29.3%) 2.44 (1.36–4.39) 2.41 (1.33–4.37) 2.51 (1.37–4.61) 2.51 (1.40–4.49) Q3 101 (15.0%) 16 (21.3%) 2.58 (1.19–5.56) 2.64 (1.27–5.49) 2.59 (1.28–5.22) 2.51 (1.13–5.58) Q1, Q2-low SES 40 (6.0%) 8 (10.7%) 3.98 (1.78–8.92) 3.21 (1.20–8.63) 4.07 (1.76–9.41) 3.76 (1.52–9.30) Ptrend <0.01 <0.01 <0.01 <0.01 Education and nSESg ≥ College, high nSES 466 (69.4%) 39 (52.0%) 1.00 (reference) 1.00 (reference) 1.00 (reference) 1.00 (reference) ≥ College, low nSES 91 (13.5%) 14 (18.7%) 2.27 (1.15–4.49) 2.05 (1.01–4.16) 2.09 (1.05–4.14) 1.92 (0.82–4.52) ≤ High school graduate, high nSES 65 (9.7%) 12 (16.0%) 1.67 (0.80–3.46) 1.72 (0.85–3.46) 1.38 (0.58–3.28) 1.50 (0.75–3.01) ≤ High school graduate, low nSES 50 (7.4%) 10 (13.3%) 2.46 (1.05–5.75) 2. 74 (1.21–6.23) 2.29 (0.99–5.32) 2.42 (1.03–5.69) NOTE: Bold font refers to statistically significant associations.
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↵aAdjusted for age at diagnosis (continuous), year of diagnosis (continuous), study eligibility (NC-BCFR high risk, NC-BCFR sporadic, SFBCS), histology (ductal, lobular, other), histologic grade (1–4, unknown), joint ERPR status (ER−PR−, ER+, or PR+, unknown), nodal involvement (none, positive, unknown), type of surgery (none, lumpectomy, mastectomy, NOS, unknown), radiation (no, yes, unknown), chemotherapy (no, yes, unknown), first subsequent primary tumor (yes, no), second subsequent primary tumor (yes, no), days between the dates of diagnosis of study qualifying tumor and the first subsequent tumor (continuous), days between the dates of diagnosis of the first and second subsequent tumor (continuous), benign breast disease (no, yes, unknown), years since last full-term pregnancy (≤2, 2–4, 5±, unknown), prediagnosis hormonal contraception use (never, ever, unknown), prediagnosis hormone therapy use (never, past, recent, unknown) and clustering by block group, and stratified by AJCC stage (I–IV, unknown).
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↵bAdjusted for age at diagnosis (continuous), study eligibility (NC-BCFR high risk, NC-BCFR sporadic, SFBCS), histology (ductal, lobular, other), histologic grade (1–4, unknown), joint ERPR status (ER−PR−, ER+, or PR+, unknown), nodal involvement (none, positive, unknown), type of surgery (none, lumpectomy, mastectomy, NOS, unknown), radiation (no, yes, unknown), chemotherapy (no, yes, unknown), first subsequent primary tumor (yes, no), second subsequent primary tumor (yes, no), days between the dates of diagnosis of study qualifying tumor and the first subsequent tumor (continuous), days between the dates of diagnosis of the first and second subsequent tumor (continuous), marital status (single/never married, married, separated/divorced, widowed, unknown) and clustering by block group, and stratified by AJCC stage (I–IV, unknown).
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↵cAdjusted for age at diagnosis (continuous), study eligibility (NC-BCFR high risk, NC-BCFR sporadic, SFBCS), histology (ductal, lobular, other), histologic grade (1–4, unknown), joint ERPR status (ER−PR−, ER+, or PR+, unknown), nodal involvement (none, positive, unknown), type of surgery (none, lumpectomy, mastectomy, NOS, unknown), radiation (no, yes, unknown), chemotherapy (no, yes, unknown), first subsequent primary tumor (yes, no), second subsequent primary tumor (yes, no), days between the dates of diagnosis of study qualifying tumor and the first subsequent tumor (continuous), days between the dates of diagnosis of the first and second subsequent tumor (continuous), grams per day of alcohol in reference year (0,≤5, 5–9, 10–14, 15±, unknown), prediagnosis BMI (≤25, 25–29, 30±, unknown), recent recreational physical activity (0, Q1/Q2, Q3/Q4, unknown) and clustering by block group, and stratified by AJCC stage (I–IV, unknown).
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↵dAdjusted for age at diagnosis (continuous), study eligibility (NC-BCFR high risk, NC-BCFR sporadic, SFBCS), histology (ductal, lobular, other), histologic grade (1–4, unknown), joint ERPR status (ER−PR−, ER+, or PR+, unknown), nodal involvement (none, positive, unknown), type of surgery (none, lumpectomy, mastectomy, NOS, unknown), radiation (no, yes, unknown), chemotherapy (no, yes, unknown), first subsequent primary tumor (yes, no), second subsequent primary tumor (yes, no), days between the dates of diagnosis of study qualifying tumor and the first subsequent tumor (continuous), days between the dates of diagnosis of the first and second subsequent tumor (continuous), percent of white patients with cancer in reporting hospital (≤25%, 25–49%, 50–74%, ≥75%, unknown), percent of patients with cancer in highest SES quintile in reporting hospital (≤25%, 25–49%, 50–74%, ≥75%, unknown), and clustering by block group, and stratified by AJCC stage (I–IV, unknown).
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↵eEducation levels (<high school graduate and high school graduate) collapsed as ≤ high school graduate.
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↵fNeighborhood SES was measured using a composite measure of 7 Census indicator measures known as the Yost SES Index (29).
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↵gSES levels collapsed as Q1 to Q3: low SES; Q4 to Q5: high SES.
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