Racial Differences in Response to Neoadjuvant Chemotherapy: Impact on Breast and Axillary Surgical Management.
Racial Differences in Response to Neoadjuvant Chemotherapy: Impact on Breast and Axillary Surgical Management.
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DOI：
10.1245/s10434-021-09657-w
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发表时间：
2021-10
影响因子：
3.7
通讯作者：
Oppong BA
中科院分区：
文献类型：
--
作者：
Relation T;Obeng-Gyasi S;Bhattacharyya O;Li Y;Eskander MF;Tsung A;Oppong BA
新辅助化疗(NAC)是乳腺癌患者越来越常用的一种方法，它有可能降低患者肿瘤的分期，从而影响乳房和腋窝的手术选择。以前的研究已经确定了肿瘤异质性、结节复发和NAC完成方面的种族差异。这份报告比较了非西班牙裔白人女性和黑人女性在乳房和腋窝手术治疗方面的NAC反应效果。对国家癌症数据库中从2010年1月1日到2016年12月31日期间接受NAC治疗的85,303名1至3期乳腺癌患者进行了回顾性研究。对黑人和白人乳腺癌患者在社会人口学和临床变量方面的差异进行了测试。这项研究确定了68880名非西班牙裔白人和16423名非西班牙裔黑人女性接受了NAC。白人女性确诊时的平均年龄为54.8岁，黑人女性为52.5岁。黑人女性中有更高比例的第三期疾病，更低分化的肿瘤和三阴性亚型。黑人女性的完全病理应答率较低，保乳手术较多，腋窝淋巴结清扫率较高，但前哨淋巴结活检较少。被降级的女性的腋窝处理显示，与前哨淋巴结活检相比，黑人女性更多地使用腋窝淋巴结清扫。黑人患者在确诊时更年轻，疾病更晚期，更有可能接受保乳手术。降级腋窝手术越来越多地被采用，但白人女性使用的比例不成比例。
Neoadjuvant chemotherapy (NAC), an increasingly used method for breast cancer patients, has the potential to downstage patient tumors and thereby have an impact on surgical options for treatment of the breast and axilla. Previous studies have identified racial disparities in tumor heterogeneity, nodal recurrence, and NAC completion. This report compares the effects of NAC response among non-Hispanic white women and black women in relation to surgical treatment of the breast and axilla. A retrospective review of 85,303 women with stages 1 to 3 breast cancer in the National Cancer Database who received NAC between 1 January 2010 and 31 December 2016 was conducted. Differences in sociodemographic and clinical variables between black patients and white patients with breast cancer were tested. The study identified 68,880 non-Hispanic white and 16,423 non-Hispanic black women who received NAC. The average age at diagnosis was 54.8 years for the white women versus 52.5 years for the black women. A higher proportion of black women had stage 3 disease, more poorly differentiated tumors, and triple-negative subtype. The black women had lower rates of complete pathologic response, more breast-conservation surgery, and higher rates of axillary lymph node dissection, but fewer sentinel lymph node biopsies. Axillary management for the women who were downstaged showed more use of axillary lymph node dissection for black women compared with sentinel lymph node biopsy. The black patients were younger at diagnosis, had more advanced disease, and were more likely to have breast-conservation surgery. De-escalating axillary surgery is being adopted increasingly but used disproportionately for white women.
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DOI：
10.1093/jnci/djv048
发表时间：
2015-06
期刊：
Journal of the National Cancer Institute
影响因子：
--
作者：
Kohler BA;Sherman RL;Howlader N;Jemal A;Ryerson AB;Henry KA;Boscoe FP;Cronin KA;Lake A;Noone AM;Henley SJ;Eheman CR;Anderson RN;Penberthy L
通讯作者：
Penberthy L
影响因子：
3.7
作者：
Mamtani A;Barrio AV;King TA;Van Zee KJ;Plitas G;Pilewskie M;El-Tamer M;Gemignani ML;Heerdt AS;Sclafani LM;Sacchini V;Cody HS 3rd;Patil S;Morrow M
通讯作者：
Morrow M
影响因子：
45.3
作者：
Killelea, Brigid K.;Yang, Vicky Q.;Lannin, Donald R.
通讯作者：
Lannin, Donald R.
影响因子：
2.6
作者：
Akinyemiju, Tomi F.;Vin-Raviv, Neomi;Budhwani, Henna
通讯作者：
Budhwani, Henna
影响因子：
120.7
作者：
Boughey, Judy C.;Suman, Vera J.;Mittendorf, Elizabeth A.;Ahrendt, Gretchen M.;Wilke, Lee G.;Taback, Bret;Leitch, A. Marilyn;Kuerer, Henry M.;Bowling, Monet;Flippo-Morton, Teresa S.;Byrd, David R.;Ollila, David W.;Julian, Thomas B.;McLaughlin, Sarah A.;McCall, Linda;Symmans, W. Fraser;Le-Petross, Huong T.;Haffty, Bruce G.;Buchholz, Thomas A.;Nelson, Heidi;Hunt, Kelly K.
通讯作者：
Hunt, Kelly K.