Breast cancer patients face more than five times the risk of mortality if they live in a food-insecure area, researchers have reported. 

A group from the University of Maryland School of Medicine in Baltimore analyzed overall survival rates among 943 patients treated with comprehensive nodal irradiation from 2016 to 2023, with findings suggesting that addressing food insecurity can improve outcomes among these patients. 

"Our findings suggest that food insecurity, characterized by limited access to nutritious and consistent meals after curative cancer treatment, may operate as an independent mortality predictor in this patient population," the group wrote. The study was published August 18 in Advances in Radiation Oncology. 

Food-insecure regions are where people lack consistent access to enough affordable, nutritious food, and cancer survivors living in these area have a known risk of increased mortality. Yet prior studies have not determined whether the inequality result from differences in cancer characteristics, treatment delivery, adherence, or food insecurity itself, the authors explained. Further, no studies have examined the issue specifically in locally advanced breast cancer (LABC) patients receiving comprehensive nodal irradiation, they noted.     

To bridge the gap, the researchers analyzed outcomes among 943 LABC patients treated with comprehensive nodal irradiation between 2016 to 2023. Food-insecure area (FIA) residence was determined at the zip code level using the USDA Food Access Research Atlas. 

According to the results, FIA residents (n = 60; 6.4%) were more likely to identify as Black and to have hypertension and diabetes mellitus. In a multivariable analysis, food insecurity emerged as an independent predictor of mortality (hazard ratio, 5.52; p=0.003), despite no differences in cancer characteristics, treatment modalities, and treatment adherence. Five-year overall survival was 74.9% for FIA residents versus 90.2% for non-FIA residents. 

"LABC patients residing in FIAs are nearly 6-times more likely to die relative to those in food-secure areas, despite having similar cancer characteristics and treatment access," the researchers wrote. 

Ultimately, the findings support residence in a food-insecure area as an independent predictor of mortality and suggest that interventions must address nutritional quality and access. Future clinical trials evaluating the impact of providing healthy food access on the development of cardiovascular risks, co-morbid conditions, and cancer outcomes in patients with LABC is warranted, the authors concluded. 

The full study is available here.