BREAST CANCER OUTCOMES IN A RACIALLY AND ETHNICALLY DIVERSE COHORT OF INSURED WOMEN
BREAST CANCER OUTCOMES IN A RACIALLY AND ETHNICALLY DIVERSE COHORT OF INSURED WOMEN
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DOI：
10.18865/ed.28.4.565
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发表时间：
2018-09-01
影响因子：
3.2
通讯作者：
Chlebowski, Rowan T.
中科院分区：
文献类型：
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作者：
Haque, Reina;Xu, Xiaoqing;Chlebowski, Rowan T.
背景：目前尚不清楚在不同的乳腺癌幸存者队列中，随后的乳腺癌结果如何因生物亚型和种族/民族而异。方法：我们对 1996 年至 2007 年间诊断的 6,154 名受保乳腺癌幸存者（AJCC TNM 0-IV 期）进行了一项前瞻性队列研究，并于 2010 年 1 月 1 日跟踪他们随后的乳腺癌事件（复发、对侧乳腺癌、转移、死亡率）。我们按种族/族裔群体和生物亚型（管腔 A、管腔 B、HER2 富集和三阴性）比较了随后的乳腺癌发病率。我们使用多变量 Cox 比例风险模型计算了 95% Cls 的风险比 (HR)，并根据社会人口统计学、癌症治疗和肿瘤特征进行了调整。结果：队列具有多样性：62.4% 为非西班牙裔白人，13.2% 为西班牙裔，14.9% 为非裔美国人，9.5% 为亚洲人。我们在 22,830 人年中确定了 1,456 起后续乳腺癌事件。尽管某些亚洲女性的后续乳腺癌粗率高于白人，但在每个生物亚型类别中，这些差异在多变量分析中消失了。考虑种族/民族因素后，与患有 Luminal A 肿瘤的女性（参考）相比，患有 Luminal B 肿瘤（调整后的 HR= 3.65，95% CI：3.08-4.32）、富含 HER2（调整后的 HR=2.81，95% CI：2.25-3.51）和三阴性（调整后的 HR=1.25，95% CI：2.25-3.51）和三阴性（调整后的 HR=1.25，95% CI：3.08-4.32）的女性： 1.01-1.54）肿瘤在统计上增加了随后患乳腺癌的风险。与风险增加具有统计学显着相关性的因素包括较高的分期、较大的肿瘤尺寸、阳性淋巴结以及未进行辅助内分泌或化疗（所有 P
Background: It is unknown how subsequent breast cancer outcomes vary by biologic subtype and race/ethnicity in a diverse cohort of breast cancer survivors.Methods: We conducted a prospective cohort study of 6,154 insured breast cancer survivors (AJCC TNM stages 0-IV) diagnosed between 1996-2007 and followed them through 1/1/2010 for subsequent breast cancer events (recurrence, contralateral breast cancer, metastasis, mortality). We compared subsequent breast cancer rates by race/ethnicity groups and biologic subtype (lumina) A, luminal B, HER2-enriched, and triple negative). We calculated hazard ratios (HRs) with 95% Cls using multivariable Cox proportional hazards models, adjusted for sociodemographics, cancer treatments, and tumor characteristics.Results: The cohort was diverse: 62.4% non-Hispanic White, 13.2% Hispanic, 14.9% African American, and 9.5% Asian. We identified 1,456 subsequent breast cancer events over 22,830 person-years. Although certain Asian women had higher crude subsequent breast cancer rates compared with Whites, within each biologic subtype category, these disparities disappeared in the multivariable analyses. After accounting for race/ethnicity, compared with women with luminal A tumors (reference), women with luminal B (adjusted HR= 3.65, 95% CI: 3.08-4.32), HER2-enriched (adjusted HR=2.81, 95% CI: 2.25-3.51) and triple negative (adjusted HR=1.25, 95% CI: 1.01-1.54) tumors had statistically increased risks of subsequent breast cancer. Factors that were statistically significantly associated with increased risk included higher stage, larger tumor size, positive lymph nodes, and no adjuvant endocrine or chemotherapy (all P