Breast cancer prognostic factors/pathobiology

描述（由申请人提供）：乳腺癌死亡率是女性癌症死亡的第二大原因。尽管在阶段和治疗进展的改善，乳腺癌的死亡率仍然是巨大的，存在着一个关于影响疾病进展和死亡率的因素缺乏见解。特别是，很少有人知道如何病人和肿瘤的特点与死亡率在中年和老年妇女。我们建议进行一项以人群为基础的分子流行病学队列研究，研究预测45岁至79岁诊断为浸润性乳腺癌的妇女死亡率的因素。这项研究的总体目标是评估患者和肿瘤特征与乳腺癌风险的关系 mortality.拟议的队列包括2337名妇女诊断为第一次浸润性乳腺癌在45-79岁期间，1993-1999年，所有这些人都完成了广泛的采访，有关暴露前诊断，现在将跟踪死亡率。电话访谈和医疗记录审查将用于收集诊断后暴露、疾病复发和治疗详情的信息。肿瘤特征和标志物将与死亡率和患者因素相关，作为了解预后决定因素的基础进行评估。本研究的目的是：（1）确定患者特征和暴露（诊断前和诊断后），包括一些可能改变的，与死于乳腺癌的风险有关，（2）确定患者特征和诊断前的暴露是否与组织病理学特征和肿瘤标志物有关，（3）评估组织病理学因素和肿瘤标志物（包括已充分表征的预后标志物和不太充分表征的细胞周期蛋白）与死于乳腺癌的风险的关系，（4）建立组织微阵列，以便在识别标记物时快速评估它们，（5）为未来的辅助研究建立全面的资源。研究肿瘤和患者特征与死亡率的关系可以提供关于预后决定因素的病因学和临床见解，并有助于产生关于乳腺癌进展生物学的线索。

DESCRIPTION (provided by applicant): Breast cancer mortality is the second leading cause of cancer death in women. In spite of improvements in stage and advances in treatment, mortality from breast cancer continues to be substantial and there exists a paucity of insights regarding factors that influence disease progression and mortality. In particular, little is known about how patient and tumor characteristics relate to mortality in middle- and older aged women. We propose to conduct a population-based molecular-epidemiologic cohort study of factors that predict mortality in women diagnosed with invasive breast cancer at ages 45 through 79. The overall goal of the study is to evaluate patient and tumor characteristics for their relationship with the risk of breast cancer mortality. The proposed cohort consists of 2337 women diagnosed with a first invasive breast cancer at 45-79 years of age during the period 1993-1999, all of whom previously completed an extensive interview regarding exposures prior to diagnosis and will now be followed for mortality. Telephone interviews and medical record reviews will be used to collect information on exposures after diagnosis, disease recurrences, and treatment details. Tumor characteristics and markers will be assessed in relation to both mortality and patient factors as a basis for understanding determinants of prognosis. The aims of this study are: (1) to determine if patient characteristics and exposures (before and after diagnosis), including some which are potentially modifiable, are related to the risk of dying from breast cancer, (2) to determine if patient characteristics and exposures prior to diagnosis are associated with histopathologic features and tumor markers, (3) to assess the relationship of histopathologic factors and tumor markers, including both well characterized prognostic markers and less well-characterized cell cycle proteins, with the risk of dying from breast cancer, (4) to build tissue microarrays that will allow rapid assessment of future markers as they are identified, (5) to build a comprehensive resource for future ancillary studies. The investigation of tumor and patient characteristics in relation to mortality could provide etiologic and clinical insights regarding determinants of prognosis and help to generate clues regarding the biology of breast cancer progression.