Carolina Breast Cancer Study

卡罗莱纳州乳腺癌研究(CBCS)第三阶段是一项成功的孢子支持研究的延续 一项以人群为基础的研究，考察乳腺癌的遗传和流行病学危险因素及特征 癌症，重点是非裔美国人(AA)和绝经前乳腺癌。研究来自于 参与CBCS I期和II期的大约2000名乳腺癌患者证明， AA种族和年龄小的患者预后不良的基底样乳腺癌患病率高， 相反，预后良好的Lumina A亚型的患病率较低。此外，重新评估 传统的风险因素表明，亚型的影响具有相当大的异质性；独特的遗传和 已经观察到生活方式因素与基底细胞样乳腺癌的相关性，有时与 根据与总体乳腺癌风险的关联，与预期相反。根据这些结果， 我们假设年轻的非裔美国人乳腺癌的发病率和死亡率较高 女性与白人女性相比是由于多种因素的综合作用，包括肿瘤生物学上的差异， 获得护理的机会和接受的治疗类型。此外，我们假设继续全面 对这些因素的调查将确定降低乳房的具体临床和公共卫生干预措施 癌症死亡率。 为了确定与每个乳腺癌亚型相关的因素，CBCS第三阶段于#年启动 2008年，将L-II期的24个县的集水区扩大到北卡罗来纳州的44个县， 到2014年，将再增加1500名再生障碍性贫血妇女和1500名非再生障碍性贫血妇女。CBCS III的目标是 确定乳腺癌临床结果差异的决定因素，包括生物学、种族、 社会经济、行为因素，并确定临床护理中的可修改因素(提供和获得) 这解决了差异的原因。CBCS第三阶段超出了单一资金来源的范围， 得到了大学和其他机制的广泛支持，但有关键的翻译 这个项目的影响。具体地说，为肿瘤的基因表达谱提供孢子资金(目标1)， 它将能够评估按亚类划分的风险因素分布的差异(目标2)，并将用于 收集治疗和结果数据以评估生存结果(目标3)。这项研究将提供一个 全面了解乳腺癌和乳腺癌的生物学和流行病学差异，来自 生存的风险。

The Carolina Breast Cancer Study (CBCS) Phase III is a continuation of a successful SPORE-supported population-based study examining genetic and epidemiologic risk factors and characteristics of breast cancer with a focus on African-American (AA) and premenopausal breast cancer. Studies from the approximately 2000 breast cancer patients participating in CBCS Phases I and II demonstrated that patients with AA race and young age had a high prevalence ofthe poor prognosis Basal-like breast cancer, and conversely a low prevalence ofthe good prognosis Luminal A subtype. Additionally, reevaluafion of traditional risk factors suggested considerable heterogeneity in effects by subtype; unique genetic and lifestyle factor associations have been observed for basal-like breast cancer, sometimes with effects in the opposite direction as expected based on associations with overall breast cancer risk. Based on these results, we hypothesize that the higher incidence and mortality from breast cancer in younger African American women compared to white women is due to a combination of factors, including differences in tumor biology, access to care, and type of treatment received. Furthermore, we hypothesize that continued comprehensive investigation of these factors will identify specific clinical and public health interventions to lower breast cancer mortality. To identify the factors that are associated with each breast cancer subtype, CBCS Phase III was opened in 2008, expanding the previous 24-county catchment area of Phases l-ll to 44 counties across North Carolina, and will accrue an additional 1500 AA women and 1500 non-AA women by 2014. The goal of CBCS III is to identify determinants of disparities in breast cancer clinical outcomes, including biologic, racial, socioeconomic, behavioral factors, and to identify modifiable factors in clinical care (delivery and access) that address the causes of disparities. CBCS Phase III is beyond the scope of a single funding source and is broadly supported by the University and other mechanisms, however there are crucial translational implications of this project. Specifically, SPORE funding for gene expression profiling on the tumors (Aim 1), which will enable evaluation of differences in risk factors distribution by subtype (Aim 2), and will be used for collection of treatment and outcome data to assess survival outcomes (Aim 3). This study will provide a comprehensive picture ofthe biology and epidemiology of breast cancer and breast cancer disparities, from risk to survival.