FACTORS AFFECTING SURVIVAL OF YOUNG CANCER PATIENTS

本项目的总体目标是确定哪些因素影响 乳腺癌患者的复发和死亡风险 45岁。 这个项目建立在1400年已经收集的信息基础上 在45岁之前被诊断患有浸润性乳腺癌的女性， 1983年至1992年，并就疾病的危险因素进行了访谈。 该队列 将随访复发率和死亡率直到1996年12月。 这些妇女占这些事件的大多数（85%）。 在华盛顿州的金、皮尔斯和斯诺霍米什县工作了多年。 在该队列中，所有复发和/或死亡的女性将接受 鉴定 这些女性将与队列中的女性进行比较 无复发和/或死亡，以下因素： 1.患者特征和风险因素收集在详细的 面谈如口服避孕药使用情况、人工流产史 和其他生殖因素，乳腺癌家族史， 乳房X光检查史肥胖等 2.手术时机与月经周期的关系。 3.组织学特征，包括组织学类型、全身 核等级，有丝分裂数，大小，多中心性，位置， 临床表现、淋巴结转移和边缘状态 通过病理检查确定的肿瘤。 4.免疫细胞化学法检测肿瘤相关蛋白的表达，包括 类固醇受体，癌基因蛋白，p53肿瘤抑制基因产物， 生长因子和增殖细胞核抗原（PCNA）。 5.通过图像分析确定的血管生成反应证据 血管密度和mRNA表达的定量 血管生成相关因素。 6.流式细胞术检测细胞增殖和非整倍体 分析福尔马林固定的S期分数和DNA含量， 石蜡包埋肿瘤 此外，我们将评估患者的关系 肿瘤的特征和暴露数据（上文1和2） 诊断时的特征（上述3 - 6）。

The overall goal of this project is to determine what factors affect the risk of recurrence and death in women diagnosed with breast cancer before age 45. This project builds on the information already collected on 1400 women who were diagnosed with invasive breast cancer before age 45 from 1983 - 1992 and interviewed about risk factors for disease. This cohort will be followed for recurrence and mortality through December, 1996. These women represent the majority (85%) of incident cases from these years in King, Pierce, and Snohomish Counties in Washington State. From within this cohort, all women with recurrence and/or death will be identified. These women will be compared to women from within the cohort without recurrence and/or death on the following factors: 1. Patient characteristics and risk factors collected in the detailed interview such as oral contraceptive use, history of induced abortion, and other reproductive factors, family history of breast cancer, mammography history, obesity, etc. 2. Timing of surgery in relation to the menstrual cycle. 3. Histopathologic characteristics including histologic type, generalized nuclear grade, number of mitoses, size, multicentricity, location, clinical presentation, lymph node metastases, and status of margins of the tumors as determined by pathologic review. 4. Expression of tumor-related proteins by immunocytochemistry, including steroid receptors, oncogene proteins, p53 tumor suppressor gene product, growth factors, and proliferating cell nuclear antigen (PCNA). 5. Evidence of angiogenic response determined by image analysis quantification of vascular density and mRNA expression of angiogenesis-related factors. 6. Cell proliferation and aneuploidy determined by flow cytometric analysis of S-phase fraction and DNA content of formalin-fixed, paraffin-embedded tumor. In addition, we will evaluate the relationship(s) of patient characteristics and exposure data (1 and 2 above) to tumor characteristics (3 - 6 above) at diagnosis.