Elevated breast cancer mortality in women younger than age 40 years compared with older women is attributed to poorer survival in early-stage disease.
Elevated breast cancer mortality in women younger than age 40 years compared with older women is attributed to poorer survival in early-stage disease.
复制标题
DOI：
10.1016/j.jamcollsurg.2008.12.001
复制
发表时间：
2009-03
影响因子：
5.2
通讯作者：
Margenthaler, Julie A.
中科院分区：
文献类型：
--
作者：
Gnerlich, Jennifer L.;Deshpande, Anjali D.;Jeffe, Donna B.;Sweet, Allison;White, Nick;Margenthaler, Julie A.
我们调查了不同诊断阶段的年轻（<40岁）和老年（≥40岁）女性乳腺癌死亡率的差异，以确定导致差异的患者和肿瘤特征。我们对1988-2003年监测、流行病学和最终结果（SEER）项目数据中诊断为乳腺癌的妇女进行了回顾性研究。多变量考克斯回归模型计算校正的风险比（aHR）和95%置信区间（CI），以比较<40岁和≥40岁女性的总体和分期特异性乳腺癌死亡率，控制单变量检验中确定的潜在混杂变量。在243，012例乳腺癌患者中，6.4%<40岁，而93.6% ≥40岁。与老年女性相比，年轻女性更可能是黑人，单身，诊断较晚，并接受乳房切除术治疗。年轻女性的肿瘤更可能是高级别、大尺寸、ER/PR阴性和淋巴结阳性（p<0.001）。与老年女性相比，年轻女性更容易死于乳腺癌（cHR 1.39，CI 1.34-1.45）。控制混杂因素，如果诊断为I期（aHR 1.44，CI 1.27-1.64）或II期（aHR 1.09，CI 1.03-1.15）疾病，与老年女性相比，年轻女性死亡的可能性更高，如果诊断为IV期疾病，死亡的可能性更低（aHR 0.85，CI 0.76-0.95）。年轻女性的乳腺癌死亡率较高归因于早期疾病的预后较差。进一步的研究应该集中在特定的肿瘤生物学有助于早期乳腺癌的年轻女性的死亡率增加。
We investigated differences in breast cancer mortality between younger (<40 yrs) and older (≥40 yrs) women by stage at diagnosis to identify patient and tumor characteristics accounting for disparities. We conducted a retrospective study of women diagnosed with breast cancer in the 1988-2003 Surveillance, Epidemiology, and End Results (SEER) Program data. Multivariate Cox regression models calculated adjusted hazard ratios (aHR) and 95% confidence intervals (CI) to compare overall and stage-specific breast cancer mortality in women <40 yrs and women ≥40 yrs, controlling for potential confounding variables identified in univariate tests. Of 243,012 breast cancer patients, 6.4% were <40 yrs, while 93.6% were ≥40 yrs. Compared with older women, younger women were more likely to be Black, single, diagnosed at later stages, and treated by mastectomy. Younger women had tumors that were more likely to be higher grade, larger size, ER/PR negative, and lymph-node positive (p<0.001). Younger women were more likely to die from breast cancer compared with older women (cHR 1.39, CI 1.34-1.45). Controlling for confounders, younger women were more likely to die compared with older women if diagnosed with Stage I (aHR 1.44, CI 1.27-1.64) or Stage II (aHR 1.09, CI 1.03-1.15) disease and less likely to die if diagnosed with Stage IV disease (aHR 0.85, CI 0.76-0.95). Higher breast cancer mortality in younger women was attributed to poorer outcomes with early stage disease. Further studies should focus on specific tumor biology contributing to the increased mortality of younger women with early stage breast cancer.
登录
查看更多内容
影响因子：
168.9
作者：
DELAROCHEFORDIERE, A;ASSELAIN, B;FOURQUET, A
通讯作者：
FOURQUET, A
影响因子：
158.5
作者：
ADAMI, HO;MALKER, B;STONE, B
通讯作者：
STONE, B
影响因子：
8.8
作者：
Kollias, J;Elston, CW;Blamey, RW
通讯作者：
Blamey, RW
影响因子：
45.3
作者：
Anders, Carey K.;Hsu, David S.;Blackwell, Kimberly L.
通讯作者：
Blackwell, Kimberly L.
DOI：
10.1073/pnas.1732912100
发表时间：
2003-09-02
影响因子：
11.1
作者：
Sotiriou, C;Neo, SY;Liu, ET
通讯作者：
Liu, ET