FACTORS AFFECTING SURVIVAL OF YOUNG CANCER PATIENTS

描述：本申请的竞争性续期“因素， 影响年轻乳腺癌患者的生存”，寻求延长五年， 多年随访复发率和死亡率的人群为基础的 一组128名女性被诊断为浸润性乳腺癌， 1983年至1992年，45岁。 这些妇女提供了 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、肿瘤 乳腺癌的发病率和/或死亡率 基于人群的设置，其中所有乳腺癌病例在一个定义的 可以评估地理区域，消除可能的偏见， 转诊中心的研究或临床试验，妇女可以自行选择 并不代表一般的隆胸妇女 癌 在过去的五年里，这一队列通过随访 问卷调查和医院病历审查，他们的肿瘤标本， 测试与攻击性和预后相关的特征。 是 重要的是将该队列的随访时间延长至至少10年，因为 患者和肿瘤特征可能与 短期和长期死亡率。 在接下来的五年里， 研究人员建议（a）扩大数据收集和样本分析， 整个队列（而不是他们最初的930个分组） （B）延长整个队列的最短随访期， （c）收集关于复发、治疗、 诊断后使用激素替代疗法和生育，（d）增加 凋亡指数进行实验室分析，以及（e）进行全面的 分析所有这些数据与死亡率和无病死亡率的关系， 生存 年轻女性与许多年的潜在生命失去谁不落入 明确的预后分类对临床医生提出了重大挑战。 通过 了解流行病学风险与 与侵袭性相关的因素和肿瘤特征， 复发或死亡的实际风险，有可能制定的概况 患有侵袭性肿瘤的高危女性， 治疗和那些低风险的肿瘤， 治疗可能是不必要的。

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.