What can we learn from the age- and race/ethnicity- specific rates of inflammatory breast carcinoma?
What can we learn from the age- and race/ethnicity- specific rates of inflammatory breast carcinoma?
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我们可以从特定年龄和种族/民族的炎性乳腺癌发病率中了解到什么？
DOI：
10.1007/s10549-011-1719-4
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发表时间：
2011
影响因子：
3.8
通讯作者：
Schildkraut,Joellen
中科院分区：
文献类型：
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作者：
Il'yasova,Dora;Siamakpour-Reihani,Sharareh;Akushevich,Igor;Akushevich,Lucy;Spector,Neil;Schildkraut,Joellen
炎症性乳腺癌（IBC）是具有独特临床病理表现的最具侵袭性的乳腺肿瘤类型，被假设具有独特的病因学和社会经济地位（SES）成分。使用2004-2007年的监测、流行病学和最终结果（SEER）计划数据，我们比较了不同SES种族/民族中IBC与非炎性局部晚期乳腺癌（LABC）的发病率。分析对象包括20-84岁的妇女。为了研究IBC不同病因的证据，我们使用数学致癌模型分析了IBC和非炎性LABC的年龄分布模式。根据协作分期扩展代码，在四年研究期间确定了2，942例偶发IBC病例（代码71和73）和5，721例非炎性LABC病例（代码40-62）。非西班牙裔白色和西班牙裔女性的IBC校正率相似（两组均为2.5/10万）。在这两组的非炎性LABC中也发现了相似的比率（分别为4.8/100，000和4.2/100，000）。在非裔美国妇女中，IBC（3.91/100，000）和非炎症LABC（8.47/100，000）的发生率高于其他种族/人种亚组。然而，在所有种族/族裔群体中，IBC/非炎性LABC的比率相似，这表明非洲裔美国妇女一般易患侵袭性乳腺肿瘤，但不特异于IBC。该数学模型成功地预测了所观察到的两种乳腺肿瘤的年龄特异性发病率，并揭示了不同的模式。IBC率增加，直到65岁，然后略有下降，而非炎性LABC率在整个年龄段稳步上升。该模型预测的IBC和非炎性LABC的临界过渡致癌阶段（m阶段）的数量分别为6.3和8.5，支持这些乳腺肿瘤的不同病因。
Inflammatory Breast Carcinoma (IBC), the most aggressive type of breast tumor with unique clinicopathological presentation, is hypothesized to have distinct etiology with a socioeconomic status (SES) component. Using the Surveillance, Epidemiology and End Results (SEER) Program data for 2004–2007, we compare incidence rates of IBC to non-inflammatory locally advanced breast cancer (LABC) among racial/ethnic groups with different SES. The analysis includes women 20–84 years of age. To examine evidence for the distinct etiology of IBC, we analyzed age-distribution patterns of IBC and non-inflammatory LABC, using a mathematical carcinogenesis model. Based on the Collaborative Staging Extension codes, 2,942 incident IBC cases (codes 71 and 73) and 5,721 non-inflammatory LABC cases (codes 40–62) were identified during the four-year study period. Age-adjusted rates of IBC among non-Hispanic White and Hispanic women were similar (2.5/100,000 in both groups). Similar rates were also found in non-inflammatory LABC in these two groups (4.8/100,000 and 4.2/100,000, respectively). In African-American women, the IBC (3.91/100,000) and non-inflammatory LABC (8.47/100,000) rates were greater compared with other ethnic/racial sub-groups. However, the ratio of rates of IBC/non-inflammatory LABC was similar among all the racial/ethnic groups, suggesting that African-American women are susceptible to aggressive breast tumors in general but not specifically to IBC. The mathematical model successfully predicted the observed age-specific rates of both examined breast tumors and revealed distinct patterns. IBC rates increased until age 65 and then slightly decreased, whereas non-inflammatory LABC rates steadily increased throughout the entire age interval. The number of critical transition carcinogenesis stages (m-stages) predicted by the model were 6.3 and 8.5 for IBC and non-inflammatory LABC, respectively, supporting different etiologies of these breast tumors.