Variation in Breast Cancer Subtype Incidence and Distribution by Race/Ethnicity in the United States From 2010 to 2015.
Variation in Breast Cancer Subtype Incidence and Distribution by Race/Ethnicity in the United States From 2010 to 2015.
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2010年至2015年美国不同种族/民族的乳腺癌亚型发病率和分布变化
DOI：
10.1001/jamanetworkopen.2020.20303
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发表时间：
2020-10-01
影响因子：
13.8
通讯作者：
Wang J
中科院分区：
文献类型：
--
作者：
Kong X;Liu Z;Cheng R;Sun L;Huang S;Fang Y;Wang J
本队列研究描述了美国女性中按人种/种族分层的4种乳腺癌分子亚型的发病率。乳腺癌亚型的发病率和患者在与人种/种族相关的临床病理学变量中的分布是否存在差异？在这项纳入239211例乳腺癌女性的队列研究中，与非西班牙裔白色女性相比，黑人女性中HR阴性和ERBB 2（以前称为HER 2）阳性、HR阳性和ERBB 2阳性以及三阴性乳腺癌的发生率更高。亚裔/太平洋岛民中组织学1级和2级癌症的发生率低于非西班牙裔白色患者，西班牙裔白色女性中浸润性导管癌、小叶癌和管状腺癌的发生率低于非西班牙裔白色女性。这项研究的结果表明，结合流行病学数据与基因组和分子分析数据可能作为未来的研究方向，并有助于缩小与种族/民族相关的乳腺癌亚型发病率和分布的差距。乳腺癌是最常见的癌症，也是全世界妇女死亡的主要原因。然而，乳腺癌发病率和分布的种族/民族差异在很大程度上仍然未知。检查与乳腺癌亚型发病率相关的人种/种族模式以及患者在临床病理学变量中的分布。这项基于人群的队列研究分析了来自监测、流行病学和最终结果（SEER）数据库的数据，该数据库收集了18个SEER癌症登记处的数据，这些登记处确定了2010年1月1日至2015年12月31日期间在美国诊断的乳腺癌患者。入选标准为（1）接受手术治疗的原发性单侧乳腺癌女性患者;（2）雌激素受体、孕激素受体和ERBB 2状态记录;（3）特定肿瘤部位的病史和组织学亚型记录;（4）患者种族/民族、肿瘤侧位、肿瘤大小、肿瘤TNM分期和肿瘤数量数据。确定并比较每个种族/民族的乳腺癌的不同分子亚型、组织学分级、病理学模式、T分期、TNM分期和肿瘤部位的发病率和分布率。患者人种/种族分类如下：非西班牙裔白色、西班牙裔白色、黑人、亚洲/太平洋岛民、美洲印第安人/阿拉斯加原住民和未知。分析了2010年1月1日至2015年12月31日的数据。4种分子亚型的发病率：激素受体（HR）阳性和ERBB 2阴性、HR阳性和ERBB 2阳性、HR阴性和ERBB 2阳性、三阴性乳腺癌（TNBC）。还提取了组织学分级（1-4级和未知）、病理模式、T分期、TNM分期和肿瘤部位的分布数据。计算年年龄标准化发病率和发病率比（IRR）及95% CI。使用多分类回归估计人种/种族病例-病例比值比。共分析了239211例乳腺癌女性（中位数[四分位数范围]），年龄60 [50-69]岁）。非西班牙裔白色女性（参考组）中所有乳腺癌的年发病率为每10万人31.3例（95%CI，31.2- 31.5），高于黑人女性的发病率（IRR，1.04; 95%CI，1.02-1.05; P <0.001）。亚裔/太平洋岛民（IRR，0.90; 95% CI，0.89-0.92; P < .001）、美洲印第安人/阿拉斯加土著（IRR，0.82; 95% CI，0.81-0.83; P < .001）和西班牙裔白色女性（IRR，0.79; 95% CI，0.75-0.83; P < .001）的发病率也较低。在黑人患者中，HR阳性和ERBB 2阳性的发生率（IRR，1.12; 95% CI，1.08-1.16; P < .001），HR阴性和ERBB 2阳性（IRR，1.46; 95% CI，1.38-1.54; P < .001），和TNBC（IRR，2.07; 95% CI，2.01-2.14; P <0.001）亚型高于非西班牙裔白色患者，但黑人女性HR阳性和ERBB 2阴性亚型的发生率较低（IRR，0.86; 95% CI，0.84-0.87; P < .001）。与非西班牙裔白色患者相比，亚洲/太平洋岛民的组织学1级（IRR，0.75; 95% CI，0.73-0.78; P < .001）和2级（IRR，0.91; 95% CI，0.89-0.93; P < .001）发生率较低。非西班牙裔白色患者有较高比例的小叶癌（9.7% [n = 15 718]）和管状腺癌（0.6% [n = 997]）（7.2% [n = 1933]; 0.3% [n = 81]），亚裔/太平洋岛民（5.7% [n = 1202]; 0.3% [n = 55]）、西班牙裔白色患者（7.2% [n = 1985]; 0.3% [n = 88]）和美洲印第安人/阿拉斯加土著患者（7.2% [n = 101]; 0.4% [n = 5]）。该队列研究发现，不同分子亚型、组织学分级、病理模式、T分期、TNM分期和肿瘤部位的发生率和比例与人种/种族相关，存在显著差异。研究结果表明，结合流行病学与基因组和分子分析数据值得进一步研究。
This cohort study describes the incidence rates of 4 breast cancer molecular subtypes stratified by race/ethnicity among women in the US. Are there variations in the incidence of breast cancer subtypes and the distribution of patients across clinicopathological variables associated with race/ethnicity? In this cohort study of 239 211 women with breast cancer, the incidence of HR-negative and ERBB2 (formerly HER2)–positive, HR-positive and ERBB2-positive, and triple-negative breast cancer was higher in Black women compared with non-Hispanic White women. The incidence of histological grade 1 and 2 cancer was lower in Asian/Pacific Islander than non-Hispanic White patients, and a lower incidence of infiltrating duct carcinoma, lobular carcinoma, and tubular adenocarcinoma was seen in Hispanic White vs non-Hispanic White women. Results of this study suggest that combining epidemiologic data with genomic and molecular profiling data may serve as a future research direction and help in closing the gap in breast cancer subtype incidences and distributions associated with race/ethnicity. Breast cancer is the most commonly diagnosed cancer and the leading cause of death in women worldwide. Yet the racial/ethnic disparity in incidences and distributions of breast cancer remains largely unknown. To examine the racial/ethnic patterns associated with the incidence of the subtypes of breast cancer and distribution of patients across clinicopathological variables. This population-based cohort study analyzed data from the Surveillance, Epidemiology, and End Results (SEER) database, which collected data from 18 SEER cancer registries that identified patients with breast cancer in the US diagnosed between January 1, 2010, and December 31, 2015. The inclusion criteria were (1) female patients with primary unilateral breast cancer who underwent surgical treatment; (2) record of estrogen receptor, progesterone receptor, and ERBB2 status; (3) record of medical history and histological subtype of the specified tumor location; and (4) data on patient race/ethnicity, lateral tumor position, tumor size, tumor TNM stage, and number of tumors. Incidence and distribution rates were identified and compared for different molecular subtypes, histological grades, pathological patterns, T stages, TNM stages, and tumor sites of breast cancers for each racial/ethnic group. Patient race/ethnicity was classified as follows: non-Hispanic White, Hispanic White, Black, Asian/Pacific Islander, American Indian/Alaskan Native, and unknown. Data were analyzed from January 1, 2010, to December 31, 2015. Incidence rates of 4 molecular subtypes: hormone receptor (HR)–positive and ERBB2-negative, HR-positive and ERBB2-positive, HR-negative and ERBB2-positive, and triple-negative breast cancer (TNBC). Data on distribution by histological grades (grades 1-4 and unknown), pathological patterns, T stages, TNM stages, and tumor sites was also extracted. Annual age-standardized incidence rates and incidence rate ratios (IRRs) were calculated with 95% CIs. Race/ethnicity case-to-case odds ratios were estimated using polytomous regression. A total of 239 211 women with breast cancer were analyzed (median [interquartile range]) age, 60 [50-69] years). The annual incidence rate of all breast cancers was 31.3 (95% CI, 31.2- 31.5) per 100 000 people in non-Hispanic White women (the reference group), which was higher compared with the incidence among Black women (IRR, 1.04; 95% CI, 1.02-1.05; P < .001). The incidence rates were also lower in Asian/Pacific Islander (IRR, 0.90; 95% CI, 0.89-0.92; P < .001), American Indian/Alaskan native (IRR, 0.82; 95% CI, 0.81-0.83; P < .001), and Hispanic White women (IRR, 0.79; 95% CI, 0.75-0.83; P < .001). In Black patients, the incidences of the HR-positive and ERBB2-positive (IRR, 1.12; 95% CI, 1.08-1.16; P < .001), HR-negative and ERBB2-positive (IRR, 1.46; 95% CI, 1.38-1.54; P < .001), and TNBC (IRR, 2.07; 95% CI, 2.01-2.14; P < .001) subtypes were higher than those in non-Hispanic White patients, but the incidence of the HR-positive and ERBB2-negative subtype in Black women was lower (IRR, 0.86; 95% CI, 0.84-0.87; P < .001). The incidences of histological grade 1 (IRR, 0.75; 95% CI, 0.73-0.78; P < .001) and grade 2 (IRR, 0.91; 95% CI, 0.89-0.93; P < .001) were lower in Asian/Pacific Islander vs non-Hispanic White patients. Non-Hispanic White patients had a higher proportion of lobular carcinoma (9.7% [n = 15 718]) and tubular adenocarcinoma (0.6% [n = 997]) than Black (7.2% [n = 1933]; 0.3% [n = 81]), Asian/Pacific Islander (5.7% [n = 1202]; 0.3% [n = 55]), Hispanic White (7.2% [n = 1985]; 0.3% [n = 88]), and American Indian/Alaskan Native patients (7.2% [n = 101]; 0.4% [n = 5]). This cohort study found notable disparities in incidences and proportions of different molecular subtypes, histological grades, pathological patterns, T stages, TNM stages, and tumor sites associated with race/ethnicity. The findings suggest that combining epidemiologic with genomic and molecular profiling data warrants further research.
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DOI：
10.1007/s10552-016-0837-z
发表时间：
2017-01
期刊：
Cancer causes & control : CCC
影响因子：
--
作者：
Charlot M;Castro-Webb N;Bethea TN;Bertrand K;Boggs DA;Denis GV;Adams-Campbell LL;Rosenberg L;Palmer JR
通讯作者：
Palmer JR
影响因子：
254.7
作者：
Torre, Lindsey A.;Bray, Freddie;Jemal, Ahmedin
通讯作者：
Jemal, Ahmedin
影响因子：
2.3
作者：
Emerson, Marc A.;Golightly, Yvonne M.;Troester, Melissa A.
通讯作者：
Troester, Melissa A.
影响因子：
3.8
作者：
Kim, Sohyun;Ko, Yeonsook;Lim, Jung-eun
通讯作者：
Lim, Jung-eun
影响因子：
3.8
作者：
Tai P;Yu E;Vinh-Hung V;Cserni G;Vlastos G
通讯作者：
Vlastos G