Oral Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

Linking social adversity to stress and coping mechanisms in breast cancer: Towards targeted interventions (126145)

Chloe J Taub 1 , Alexandra E Hernandez 2 , Peter Borowsky 2 , Molly Ream 3 , Rachel Plotke 4 , Maya Lubarsky 5 , Elizabeth Reguero 2 , Susan Kesmodel 2 , Michael Antoni 4 , Neha Goel 6
  1. University of Alabama at Birmingham, Birmingham, ALABAMA, United States
  2. Surgery, University of Miami, Miami, FL, USA
  3. Dana-Farber Cancer Institute, Boston, MA, USA
  4. Psychology, University of Miami, Coral Gables, FL, USA
  5. Case Western Reserve University Hospitals, Cleveland, OH, USA
  6. Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA

Background. Social adversity stemming from neighborhood disadvantage (ND), which is often objectively quantified using the Area Deprivation Index [ADI], has been linked to an amplified psychophysiologic stress response, more aggressive tumor biology, and poorer survival in breast cancer (BC). As some subjective experiences of ND may be modifiable through psychosocial interventions with appropriate tailoring, this study investigates the less understood factor of social adversity perceptions and its relationship with stress and coping.

Sample and setting. Between 2020-2024, 610 adult patients receiving treatment for BC at a National Cancer Institute-designated cancer center and sister hospital in Florida enrolled in a cohort study.

Procedures. Participants completed a baseline questionnaire assessing neighborhood-level adversity (Neighborhood Social Environment Adversity Survey [NSEAS]), individual-level perceived stress (Perceived Stress Scale [PSS], Impact of Event Scale-Intrusions [IES-I]), and coping mechanisms (John Henryism Active Coping Scale [JHAC], Social Provisions Scale [SPS], Management of Current Stress [MOCS]). ADI was obtained using residential addresses. Multiple regression analyses, controlling for age, race/ethnicity, and income, tested relationships between social adversity, stress, and coping variables (significance: p<.05).

Results. Objective social adversity [ADI] was associated with greater subjective social adversity [NSEAS], and greater subjective social adversity was related to greater general [PSS], but non-cancer-specific stress [IES-I]. Additionally, women reporting stronger coping mechanisms – characterized by higher active coping, social support, and coping skill confidence [JHAC, SPS, MOCS] – perceived less social adversity.

Conclusion and clinical implications. These insights provide a basis for psychosocial programs aimed at reducing stress related to social adversity, which, according to prior translational findings, may buffer against heightened aggressive biology and lead to improved cancer outcomes. Targeted psychosocial content bolstering the identified coping skills and resources could fit within a comprehensive, multi-level intervention approach that also aims to address important objective ND factors, such as built environment modifications and policy changes.