Food Deserts Link to Aggressive Breast Cancer Biology and Survival Gaps

A patient’s ZIP code may be just as influential as their genetic code when it comes to surviving metastatic breast cancer. New research presented at the 2026 American Society of Clinical Oncology (ASCO) Annual Meeting suggests that living in a "food desert" is linked to more aggressive tumor biology and significantly shorter survival rates.

Dr. Emily L. Podany, an assistant professor at the Washington University School of Medicine in St. Louis, led a multi-institutional study of 851 patients to investigate how food access and poverty intersect with the genomic profile of metastatic breast cancer (MBC). The findings reveal a sobering reality: Social determinants of health do not just affect a patient’s ability to get to the clinic; they appear to influence how the cancer itself behaves.

Biological drivers in food deserts

The study categorized patients based on their proximity to food stores. "Low access" (LA) was defined as living more than one mile from a grocery store in urban areas or 10 miles in rural areas. Patients in these food deserts were twice as likely to harbor RTK/RAS pathway mutations, which are known to drive tumor growth.

For those living in "low-income and low-access" (LILA) areas where poverty rates reach 20% or higher the genomic outlook was even more challenging. These patients were nearly three times as likely to have CCNE1 copy number variants, a genomic marker associated with a poor prognosis.

"We now have a growing body of evidence that these social determinants of health ... actually matter for your breast cancer treatment," Podany said in an interview at the meeting. "Not just for getting treatments and getting to treatments like transportation, but also how the breast cancer itself is acting."

A stark survival gap

The biological differences translated into a significant survival disadvantage. Patients in food deserts had a median overall survival of 24 months, compared to 31 months for those with high food access.

The disparity was most extreme among Black patients with hormone receptor-positive, HER2-negative MBC. Black patients living in low-access areas had a median overall survival of just 11 months, while those in high-access areas lived for a median of 38 months.

Creating a supportive environment

Podany emphasized that addressing these disparities requires more than just medical intervention; it requires a shift in how doctors communicate with their patients. She noted that admitting to food insecurity is often one of the most difficult things for a person to do.

"I've heard from patient advocates, this is one of the most difficult things for somebody to admit to or talk about, to say, 'You know, actually, I don't have access to this healthy food,'" Podany explained.

To combat this, she encourages physicians to create a "warm environment" where the focus remains on personalizing care to get the best possible outcome. The goal, she says, is to ensure that breast cancer does not grow in a way that could have been prevented by providing access to healthy foods and proper social support.

As oncology moves toward more targeted therapies, Podany’s research serves as a reminder that treating the tumor is only half the battle; clinicians must also treat the environment in which the patient lives

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