US Incidence of Breast Cancer Subtypes Defined by Joint Hormone Receptor and HER2 Status
US Incidence of Breast Cancer Subtypes Defined by Joint Hormone Receptor and HER2 Status
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DOI：
10.1093/jnci/dju055
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发表时间：
2014-05-14
影响因子：
10.3
通讯作者：
Cronin, Kathleen A.
中科院分区：
文献类型：
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作者：
Howlader, Nadia;Altekruse, Sean F.;Cronin, Kathleen A.
2010年，监测、流行病学和最终结果（SEER）登记处开始收集乳腺癌病例的人表皮生长因子2 （HER2）受体状态。方法通过联合激素受体（HR；雌激素受体[ER]和孕激素受体[PR]）和HER2状态对美国28%的SEER登记人群进行评估。按亚型计算非西班牙裔（NH）白人、NH黑人、NH亚太岛民（API）和西班牙裔女性的年龄特异性发病率。采用多变量调整多元逻辑回归评估年龄、种族/民族、县级贫困、登记、分期、Bloom-Richardson分级、肿瘤大小和淋巴结状态的联合HR/HER2状态分布。所有统计检验均为双侧检验。结果在已知HR/HER2状态的患者中，HR+/HER2(-) 36810例（72.7%），HR-/HER2（-）三阴性6193例（12.2%），HR+/HER2(+) 5240例（10.3%），HR-/HER2(+) 2328例（4.6%）；6912例（12%）患者HR/HER2状态未知。NH白人女性的HR+/HER2（-）亚型发病率最高，NH黑人女性的三阴性亚型发病率最高。与患有HR+/HER2（-）亚型的女性相比，三阴性患者更有可能是NH黑人和西班牙裔；HR+/HER2（+）患者更有可能是NH API；HR-/HER2（+）患者更可能是NH黑人、NH API和西班牙裔。与HR+/HER2（-）患者相比，三阴性、HR+/HER2（+）和HR-/HER2（+）乳腺癌患者在老年时被诊断的可能性低10%至30%，出现高级别疾病的可能性高6.4倍至20.0倍。在未来，SEER数据可用于监测美国人口中很大一部分（约28%）被诊断为不同分子亚型乳腺癌的女性的临床结果。
Background In 2010, Surveillance, Epidemiology, and End Results (SEER) registries began collecting human epidermal growth factor 2 (HER2) receptor status for breast cancer cases.Methods Breast cancer subtypes defined by joint hormone receptor (HR; estrogen receptor [ER] and progesterone receptor [PR]) and HER2 status were assessed across the 28% of the US population that is covered by SEER registries. Age-specific incidence rates by subtype were calculated for non-Hispanic (NH) white, NH black, NH Asian Pacific Islander (API), and Hispanic women. Joint HR/HER2 status distributions by age, race/ethnicity, county-level poverty, registry, stage, Bloom-Richardson grade, tumor size, and nodal status were evaluated using multivariable adjusted polytomous logistic regression. All statistical tests were two-sided.Results Among case patients with known HR/HER2 status, 36 810 (72.7%) were found to be HR+/HER2(-), 6193 (12.2%) were triple-negative (HR-/HER2(-)), 5240 (10.3%) were HR+/HER2(+), and 2328 (4.6%) were HR-/HER2(+); 6912 (12%) had unknown HR/HER2 status. NH white women had the highest incidence rate of the HR+/HER2(-) subtype, and NH black women had the highest rate of the triple-negative subtype. Compared with women with the HR+/HER2(-) subtype, triple-negative patients were more likely to be NH black and Hispanic; HR+/HER2(+) patients were more likely to be NH API; and HR-/HER2(+) patients were more likely to be NH black, NH API, and Hispanic. Patients with triple-negative, HR+/HER2(+), and HR-/HER2(+) breast cancer were 10% to 30% less likely to be diagnosed at older ages compared with HR+ /HER2(-) patients and 6.4-fold to 20.0-fold more likely to present with high-grade disease.Conclusions In the future, SEER data can be used to monitor clinical outcomes in women diagnosed with different molecular subtypes of breast cancer for a large portion (approximately 28%) of the US population.