Racial disparity in survival from estrogen and progesterone receptor-positive breast cancer: implications for reducing breast cancer mortality disparities.
Racial disparity in survival from estrogen and progesterone receptor-positive breast cancer: implications for reducing breast cancer mortality disparities.
复制标题
DOI：
10.1007/s10549-017-4166-z
复制
发表时间：
2017-06
影响因子：
3.8
通讯作者：
Hoskins K
中科院分区：
文献类型：
--
作者：
Rauscher GH;Silva A;Pauls H;Frasor J;Bonini MG;Hoskins K
非拉丁裔黑人乳腺癌患者的生存期比非拉丁裔白人患者短。我们比较了黑人和白人雌激素和/或孕激素受体阳性肿瘤患者的乳腺癌特异性生存率，这些肿瘤通常以内分泌治疗为目标。使用从伊利诺伊州芝加哥的乳腺癌患者人群队列中收集的数据，生成Kaplan Meier生存曲线和风险函数，并估计比例风险模型，以确定乳腺癌死亡时间的黑白差异，同时调整诊断年龄、患者特征、治疗相关变量以及肿瘤分级和分期。在回归模型中，在所有测试的模型中，黑人ER/PR阳性患者的乳腺癌死亡风险至少是白人患者的4倍。值得注意的是，即使在调整了诊断阶段、肿瘤分级和治疗变量（包括开始全身辅助治疗）后，黑人和白人女性因ER/PR阳性乳腺癌死亡的风险比为4.39 （95% CI: 1.76, 10.9, p=0.001）。我们观察到，被诊断为ER/PR阳性肿瘤的患者的乳腺癌生存率存在种族差异，这似乎不是由于黑人患者的肿瘤分期、分级或治疗开始的差异，这表明激素受体阳性肿瘤的分子特征可能存在种族差异，因此黑人患者的ER/PR阳性肿瘤可能对标准治疗反应较差。
Non-Latina black breast cancer patients experience a shorter survival from breast cancer than their non-Latina white counterparts. We compared breast cancer specific survival for the subset of black and white patients with estrogen and/or progesterone receptor positive tumors that are generally targeted with endocrine therapy. Using data collected from a population-based cohort of breast cancer patients from Chicago, IL, Kaplan Meier survival curves and hazard functions were generated and proportional hazards models were estimated to determine the black/white disparity in time to death from breast cancer while adjusting for age at diagnosis, patient characteristics, treatment-related variables, and tumor grade and stage. In regression models, hazard of breast cancer death among ER/PR positive patients was at least 4 times higher for black than for white patients in all models tested. Notably, even after adjusting for stage at diagnosis, tumor grade, and treatment variables (including initiation of systemic adjuvant therapies), the hazard ratio for death from ER/PR positive breast cancer between black and white women was 4.39 (95% CI: 1.76, 10.9, p=0.001). We observed a racial disparity in breast cancer survival for patients diagnosed with ER/PR positive tumors that did not appear to be due to differences in tumor stage, grade or therapy initiation in black patients, suggesting that there may be racial differences in the molecular characteristics of hormone receptor positive tumors, such that ER/PR positive tumors in black patients may be less responsive to standard treatments.