Association of inflammatory and noninflammatory breast cancer with socioeconomic characteristics in the surveillance, epidemiology, and end results database, 2000-2007

Jennifer A. Schlichting, Amr S. Soliman, Catherine Schairer, Mousumi Banerjee, Laura S. Rozek, David Schottenfeld, Joe B. Harford, Sofia D. Merajver

Research output: Contribution to journalArticle

19 Scopus citations


Background: Inflammatory breast cancer (IBC) is a rare and highly aggressive form of primary breast cancer. Little is known about the risk factors for IBC, specifically the association with socioeconomic position (SEP). Methods: The association between breast cancer type (IBC vs. non-IBC) with county-level SEP in the Surveillance, Epidemiology, and End Results database for cases diagnosed from 2000 to 2007 was examined. County-level SEP characteristics included metropolitan versus non-metropolitan residence, percentage below the poverty level, percentage less than high-school graduate, and an index combining the poverty and high-school variables. IBC and non-IBC age-adjusted incidence rates were calculated, stratified on SEP and race/ethnicity. The odds of IBC versus non-IBC given a particular SEP characteristic, adjusting for age and race/ethnicity, was examined through fitting of hierarchical logistic regression models (HLM). Results: Incidence rates for IBC generally increased as SEP decreased, whereas the opposite was found for non-IBC. HLM results showed that low SEP is associated with higher odds of IBC: highest (≥20%) versus lowest (<10%) persons below the poverty level [OR (95% confidence interval, CI) = 1.25 (1.09-1.43)]; highest (>28.76%) versus lowest (≤15.99%) persons less than high-school graduate [OR (95% CI) = 1.25 (1.10-1.42)]; and low SEP as measured by poverty-high school index versus high SEP [OR (95% CI) = 1.26 (1.11-1.44)]. Conclusion: Overall breast cancer has been found to be positively associated with SEP, whereas in this analysis, IBC was associated with decreasing SEP. Impact: Studies focused on understanding the disparity in IBC incidence, as well as interventions to eliminate these differences are needed.

Original languageEnglish (US)
Pages (from-to)155-165
Number of pages11
JournalCancer Epidemiology Biomarkers and Prevention
Issue number1
Publication statusPublished - Jan 1 2012


ASJC Scopus subject areas

  • Epidemiology
  • Oncology

Cite this