Odds ratios with 95% CI of having distant metastatic breast cancer versus carcinoma in situ based on Total and individual environmental quality index domain indices (Air, Water, Land, Sociodemographic (Socio), and Built domains) in (A) non-stratified and urban/rural category strata (B) metropolitan urbanized, (C) non-metro urbanized, and (D) less populated. First quartile EQI (best environmental quality) is reference and models adjusted for individual age, BMI, smoking status, and race. Filled circles represent significant odds ratios at p<0.05, and the p-trend is included where p-trend<0.05.