TUMOR BIOLOGIC FACTORS AND BREAST-CANCER PROGNOSIS AMONG WHITE, HISPANIC, AND BLACK-WOMEN IN THE UNITED-STATES
TUMOR BIOLOGIC FACTORS AND BREAST-CANCER PROGNOSIS AMONG WHITE, HISPANIC, AND BLACK-WOMEN IN THE UNITED-STATES
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DOI：
10.1093/jnci/86.9.705
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发表时间：
1994-05-04
期刊：
影响因子：
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通讯作者：
OSBORNE, CK
中科院分区：
文献类型：
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作者：
ELLEDGE, RM;CLARK, GM;OSBORNE, CK
Background: In the United States, prognosis and survival after the diagnosis of breast cancer is poorer among black patients and, to a lesser extent, among Hispanic patients, compared with white patients. Patients who are black or Hispanic have been reported to present with higher stage or more advanced disease. Even after adjusting for stage, however, survival rates are lower for blacks but not for Hispanics. Purpose: Our purpose was to compare survival, age, tumor size, nodal status, estrogen-receptor (ER) and progesterone-receptor (PgR) status, histologic type, S-phase fraction, DNA ploidy status, HER-2/neu protein expression, and p53 protein status, along with systemic treatment, in a large group of white, black, and Hispanic U.S. women. Methods: From 1970 to 1991, breast tumor specimens were submitted to The University of Texas Health Science Center from 31 contributing hospitals throughout the United States for ER and PgR assay. A total of 4885 white, 1016 black, and 777 Hispanic women were eligible for this study. Median follow-up was 57 months. Results: Overall, white women were significantly more likely to be older and to have smaller tumors, have less lymph node involvement, have tumors with positive ER and PgR status, and have a lower S-phase fraction compared with Hispanic or black women. There were no clinically important differences in DNA ploidy, histologic type, HER-2/neu, and p53 expression among the three groups. Considering all stages, white women had the best overall survival (date of diagnosis to date of death) at 5 years-75% +/- 1% (means +/- SE), with a median survival of 166 months, but Hispanic women had an intermediate survival-70% +/- 2% (median survival, 156 months), and black women had the worst survival-65% +/- 2% (median survival, 117 months) (P
