The shape of age-incidence curves of female breast cancer by hormone-receptor status
The shape of age-incidence curves of female breast cancer by hormone-receptor status
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DOI：
10.1023/a:1008970121595
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发表时间：
1999-10-01
影响因子：
2.3
通讯作者：
Potter, JD
中科院分区：
文献类型：
--
作者：
Yasui, Y;Potter, JD
目的：绝经后卵巢激素水平的大幅下降在乳腺癌的病因中起着重要作用。然而，激素必须与特定的受体结合才能引发生物反应。因此，我们假设并检验了年龄特定的乳腺癌风险，尤其是绝经后的变化，是否因雌激素和孕激素受体(ER/PR)状态的不同而不同。方法：通过将丹麦乳腺癌合作组织3359例患者的年龄特定ER/PR分布乘以丹麦国家年龄特定发病率来估计年龄特定发病率。结果：ER+/PR+亚型(占全部病例的62.9%)的发病率随着年龄的增长而持续增加，并在44岁左右突然下降。ER-/PR-亚型的发生率(17.6%)在50岁以前随年龄增加而增加，但此后保持不变。ER+/PR-亚型的发生率在绝经期迅速增加(13.9%)，但仅在绝经期后略有增加。ER-/PR+亚型的发生率(5.6%)在43岁左右逐渐升高，之后逐渐下降。国际比较显示，与日本女性相比，西方女性，特别是老年女性患ER+/PR+亚型的风险可能显著更高。结论：不同年龄的乳腺癌风险因ER/PR状况而异。乳腺癌发病率的国际差异可能在很大程度上是由ER+/PR+亚型的风险差异造成的。
Objectives: Substantial decline of ovarian hormones at menopause plays an important role in breast cancer etiology. Hormones must bind to specific receptors to elicit biological responses, however. We therefore hypothesized and examined whether the age-specific risk of breast cancer, especially its change at menopause, differs by estrogen and progesterone receptor (ER/PR) status.Methods: Age-specific incidence rates, stratified by ER/PR status, were estimated by multiplying the age-specific ER/PR distribution among 3359 cases in the Danish Breast Cancer Cooperative Group by Danish national age-specific incidence rates. International variations in the age-incidence curve were also reviewed in relation to the hypothesis.Results: The incidence of ER + /PR + subtype (62.9% of all cases) increased with age continually, with a sudden decrease in the rate of increase around age 44. The incidence of ER - /PR - subtype (17.6%) increased with age prior to about age 50 but remained unchanged subsequently. The incidence of ER + /PR- subtype (13.9%) increased rapidly during the menopausal period but only slightly afterwards. The incidence of ER - /PR + subtype (5.6%) increased until about age 43 and decreased subsequently. The international comparison revealed Western women, particularly the elderly, might be at substantially higher risk for ER + /PR + subtype compared to Japanese women.Conclusion: Age-specific risk of breast cancer differs by ER/PR status. The large international variation of breast cancer incidence rates may be explained largely by the risk difference for ER + /PR + subtype.