Racial disparities in survival outcomes among breast cancer patients by molecular subtypes.
Racial disparities in survival outcomes among breast cancer patients by molecular subtypes.
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DOI：
10.1007/s10549-020-05984-w
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发表时间：
2021-03
影响因子：
3.8
通讯作者：
Huo D
中科院分区：
文献类型：
--
作者：
Zhao F;Copley B;Niu Q;Liu F;Johnson JA;Sutton T;Khramtsova G;Sveen E;Yoshimatsu TF;Zheng Y;Ibraheem A;Jaskowiak N;Nanda R;Fleming GF;Olopade OI;Huo D
肿瘤生物学、基因组结构和医疗保健提供模式的差异导致了美国白色和黑人患者之间的乳腺癌死亡率差距。虽然这种差距在以前的文献中已经有了很好的记录，但仍然不确定种族对不同生存结局和四种乳腺癌亚型的实际影响大小有多大。我们在芝加哥大学综合癌症中心建立了一个乳腺癌患者队列。我们选择了五个主要的生存结果进行研究：总生存期，无复发生存期，乳腺癌特异性生存期，复发时间和复发后生存期。使用考克斯比例风险模型估计黑人和白色患者之间的风险比，调整选定的患者、肿瘤和治疗特征，并按四种乳腺癌亚型分层。该研究包括2795例I-III期乳腺癌患者（54%为白色，38%为黑人）。在调整所选患者、肿瘤和治疗特征后，黑人患者在所有五个生存结局方面仍比白色患者差。在HR−/HER 2+亚组中，总生存期（风险比= 4.00，95% CI：1.47-10.86）和无复发生存期（风险比= 3.00，95% CI：1.36-6.60）的种族差异最大，校正了诊断时的年龄、癌症分期和合并症。HR+/HER 2 −组在总生存期和无复发生存期方面也存在显著的种族差异。我们的研究证实，在生存和复发方面，白色和黑人乳腺癌患者之间存在种族差异，并发现这种差异在HR−/HER 2+和HR+/HER 2 −患者中最大。
Differences in tumor biology, genomic architecture, and health care delivery patterns contribute to the breast cancer mortality gap between White and Black patients in the US. Although this gap has been well documented in previous literature, it remains uncertain how large the actual effect size of race is for different survival outcomes and the four breast cancer subtypes. We established a breast cancer patient cohort at the University of Chicago Comprehensive Cancer Center. We chose five major survival outcomes to study: overall survival, recurrence-free survival, breast-cancer-specific survival, time-to-recurrence and post-recurrence survival. Cox proportional hazards models were used to estimate the hazard ratios between Black and White patients, adjusting for selected patient, tumor and treatment characteristics, and also stratified by the four breast cancer subtypes. The study included 2795 stage I-III breast cancer patients (54% White and 38% Black). After adjusting for selected patient, tumor and treatment characteristics, Black patients still did worse than White patients in all five survival outcomes. The racial difference was highest within the HR−/HER2+ subgroup, in both overall survival (hazard ratio = 4.00, 95% CI: 1.47–10.86) and recurrence-free survival (hazard ratio = 3.00, 95% CI: 1.36–6.60), adjusting for age at diagnosis, cancer stage and comorbidities. There was also a significant racial disparity within the HR+/HER2− group in both overall survival and recurrence-free survival. Our study confirmed that racial disparity existed between White and Black breast cancer patients in terms of both survival and recurrence, and found that this disparity was largest among HR−/HER2+ and HR+/HER2− patients.
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DOI：
10.1158/1078-0432.ccr-10-1533
发表时间：
2010-12-15
期刊：
Clinical cancer research : an official journal of the American Association for Cancer Research
影响因子：
--
作者：
O'Brien KM;Cole SR;Tse CK;Perou CM;Carey LA;Foulkes WD;Dressler LG;Geradts J;Millikan RC
通讯作者：
Millikan RC
DOI：
10.1158/1055-9965.epi-15-0243
发表时间：
2015-07
期刊：
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
影响因子：
--
作者：
Tao L;Gomez SL;Keegan TH;Kurian AW;Clarke CA
通讯作者：
Clarke CA
影响因子：
7.2
作者：
DEYO, RA;CHERKIN, DC;CIOL, MA
通讯作者：
CIOL, MA
DOI：
10.6004/jnccn.2014.0058
发表时间：
2014-04-01
影响因子：
13.4
作者：
Gradishar, William J.;Anderson, Benjamin O.;Kumar, Rashmi
通讯作者：
Kumar, Rashmi
影响因子：
45.3
作者：
Partridge, AH;Wang, PS;Avorn, J
通讯作者：
Avorn, J