FACTORS AFFECTING SURVIVAL OF YOUNG CANCER PATIENTS

描述：本申请为竞争性续签的“因素” 年轻乳腺癌患者的影响生存“，寻求延长五年 以人群为基础的复发率和死亡率的多年随访 128名既往被诊断为浸润性乳腺癌的女性队列 从1983年到1992年，年龄45岁。这些女性提供了 调查人员有一个独特的机会来调查 流行病学危险因素数据与肿瘤的相互关系 特征，以及乳腺癌的发生和/或死亡率 以人群为基础的环境，所有乳腺癌病例都在一个明确的 可以评估地理区域，消除由 转诊中心的研究或临床试验，妇女可以在那里自己选择 并不能代表一般乳房丰满的女性 癌症。 在过去的五年中，对这一队列进行了跟踪调查 问卷调查和医院病历回顾，他们的肿瘤标本 测试与攻击性和预后相关的特征。它是 重要的是将这一队列的后续行动延长到至少十年 患者和肿瘤的特征可能与 短期和长期死亡率。在未来的五年里， 调查员提议：(A)扩大数据收集和样本分析，以 整个队列(而不是他们最初的930个子组 拟议)，(B)将整个队列的最低后续行动期限延长至 十年，(C)收集关于复发、治疗、 在确诊后使用激素替代疗法和生育，(D)增加 对细胞凋亡指数进行实验室分析，并(E)进行全面 对所有这些数据与死亡率和无疾病的关系进行分析 生死存亡。 有多年潜在生命可能失去的年轻女性不会坠入 明确的预后分类是临床医生面临的主要挑战。通过 加深对流行病风险之间的联系的理解 与侵袭性相关的因素和肿瘤特征以及 复发或死亡的实际风险，就有可能制定出 患有侵袭性肿瘤的高危女性，她们可能从侵袭性肿瘤中受益 治疗和那些患有低风险肿瘤的人，对他们来说， 治疗可能不是必要的。

DESCRIPTION: This application for a competitive renewal of "Factors that affec survival of young breast cancer patients", seeks to extend for five more years the follow-up for recurrence and mortality of a population-based cohort of 128 women who were diagnosed with invasive breast cancer before age 45 during the years 1983 through 1992. These women provide the investigators with a unique opportunity to investigate the interrelationships between epidemiologic risk factor data, tumor characteristics, and breast cancer occurrence and/or mortality in a population-based setting where all cases of breast cancer in a defined geographic area could be assessed, eliminating potential biases impose by studies at referral centers or clinical trials, where women may self-select into the study and not be representative of women in general who get breast cancer. During the past five years, this cohort was followed through follow-up questionnaires and hospital chart reviews, and their tumor specimens were tested for characteristics related to aggressiveness and prognosis. It is important to extend follow-up of this cohort to a minimum of ten years since patient and tumor characteristics may have different relationships with short and long-term mortality. During the next five years, the investigators propose to (a) expand data collection and specimen analyses to the entire cohort (rather than the subgroup of 930 they originally proposed), (b) extend the minimum follow-up period for the entire cohort to ten years, (c) collect updated information on recurrences, treatment, the use of hormone replacement therapy and childbearing after diagnosis, (d) add apoptotic index to the laboratory analyses, and (e) conduct comprehensive analyses of all of these data in relation to mortality and disease-free survival. Young women with many years of potential life to lose who do not fall into clear prognostic categories present a major challenge to clinicians. By gainin an understanding of the association between epidemiologic risk factors and tumor characteristics related to aggressiveness as well as actual risk of recurrence or death, it is possible to develop profiles of women at high risk for aggressive tumors who might benefit from aggressive treatment and of those with low risk tumors for whom such aggressive treatment may not be necessary.