Breast Cancer Mortality After a Diagnosis of Ductal Carcinoma In Situ
Breast Cancer Mortality After a Diagnosis of Ductal Carcinoma In Situ
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DOI：
10.1001/jamaoncol.2015.2510
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发表时间：
2015-10-01
期刊：
影响因子：
28.4
通讯作者：
Sun, Ping
中科院分区：
文献类型：
--
作者：
Narod, Steven A.;Iqbal, Javaid;Sun, Ping
乳腺导管原位癌（DCIS）或0期乳腺癌的女性通常会发生第二原发性乳腺癌目的评估乳腺癌诊断后10年和20年的死亡率，并确定死亡率是否受诊断时的年龄、种族和接受的初始治疗的影响。地点和参与者：对1988年至2011年在监测、流行病学和最终结果（SEER）18登记数据库中诊断为DCIS的女性进行观察性研究。对108196名女性的诊断年龄、种族/民族、病理特征、第二原发性乳腺癌的发生日期、死亡原因和生存率进行了分析。他们死于乳腺癌的风险与一般人群中的妇女进行了比较。考克斯比例风险分析被用来估计DCIS死亡的风险比（HR），这些风险比是由诊断时的年龄、临床特征、种族和治疗决定的。诊断DCIS时的平均（范围）年龄为53.8（15-69）岁，平均（范围）随访持续时间为7.5（0-23.9）年。20年时，乳腺癌特异性死亡率为3.3%（95% CI，3.0%-3.6%），35岁之前接受诊断的女性高于老年女性（7.8%对3.2%; HR，2.58 [95%CI，1.85-3.60]; P <0.001），黑人与非西班牙裔白人相比（7.0%对3.0%; HR，2.55 [95%CI，2.17-3.01]; P <0.001）。
IMPORTANCE Women with ductal carcinoma in situ (DCIS), or stage 0 breast cancer, often experience a second primary breast cancer (DCIS or invasive), and some ultimately die of breast cancer.OBJECTIVE To estimate the 10- and 20-year mortality from breast cancer following a diagnosis of DCIS and to establish whether the mortality rate is influenced by age at diagnosis, ethnicity, and initial treatment received.DESIGN, SETTING, AND PARTICIPANTS Observational study of women who received a diagnosis of DCIS from 1988 to 2011 in the Surveillance, Epidemiology, and End Results (SEER) 18 registries database. Age at diagnosis, race/ethnicity, pathologic features, date of second primary breast cancer, cause of death, and survival were abstracted for 108 196 women. Their risk of dying of breast cancer was compared with that of women in the general population. Cox proportional hazards analysis was performed to estimate the hazard ratio (HR) for death from DCIS by age at diagnosis, clinical features, ethnicity, and treatment.MAIN OUTCOMES AND MEASURES Ten-and 20-year breast cancer-specific mortality.RESULTS Among the 108 196 women with DCIS, the mean (range) age at diagnosis of DCIS was 53.8 (15-69) years and the mean (range) duration of follow-up was 7.5 (0-23.9) years. At 20 years, the breast cancer-specific mortality was 3.3%(95% CI, 3.0%-3.6%) overall and was higher for women who received a diagnosis before age 35 years compared with older women (7.8% vs 3.2%; HR, 2.58 [95% CI, 1.85-3.60]; P < .001) and for blacks compared with non-Hispanic whites (7.0% vs 3.0%; HR, 2.55 [95% CI, 2.17-3.01]; P