Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305-5405, USA.
Breast Cancer Res. 2010;12(6):R99. doi: 10.1186/bcr2780. Epub 2010 Nov 19.
Breast cancer comprises clinically distinct subtypes, but most risk statistics consider breast cancer only as a single entity. To estimate subtype-specific lifetime breast cancer risks, we took advantage of population-based data for which information regarding tumor expression of estrogen receptor (ER), progesterone receptor (PR) and HER2/neu (HER2) was newly available.
We included women whose breast cancer was diagnosed in the state of California from 2006 to 2007 and was reported to the National Cancer Institute's Surveillance, Epidemiology and End Results Program (N = 40,936). We calculated absolute lifetime and age-specific probabilities (percent, 95% confidence interval) of developing breast cancer subtypes defined by ER, PR, and HER2 status - luminal (ER and/or PR-positive, HER2-negative), HER2-positive (ER and PR-positive or negative, HER2-positive), and triple-negative (ER-negative, PR-negative, and HER2-negative) - separately for white, black, Hispanic, and Asian women.
The luminal breast cancer subtype predominates across racial/ethnic groups, with lifetime risk lowest in Hispanic women (4.60%, 4.41-4.80%) and highest in white women (8.10%, 7.94-8.20%). HER2-positive breast cancer varies less by race (1.56-1.91%). Lifetime risk of triple-negative breast cancer is highest in black women (1.98%, 1.80-2.17%), compared to 0.77% (0.67-0.88%) for Asians, 1.04% (0.96-1.13%) for Hispanics and 1.25% (1.20-1.30%) for whites. Across racial/ethnic groups, nearly half of all luminal breast cancers occur after age 70.
These absolute risk estimates may inform health policy and resource planning across diverse populations, and can help patients and physicians weigh the probabilities of developing specific breast cancer subtypes against competing health risks.
乳腺癌包含临床上明显不同的亚型，但大多数风险统计数据仅将乳腺癌视为单一实体。为了估计特定亚型的终生乳腺癌风险，我们利用了基于人群的数据，这些数据中关于雌激素受体（ER）、孕激素受体（PR）和 HER2/neu（HER2）的肿瘤表达信息是新获得的。
我们纳入了 2006 年至 2007 年在加利福尼亚州诊断为乳腺癌并向美国国家癌症研究所的监测、流行病学和最终结果计划（N = 40,936）报告的女性。我们计算了按 ER、PR 和 HER2 状态定义的乳腺癌亚型的绝对终生和年龄特异性概率（百分比，95%置信区间）- luminal（ER 和/或 PR 阳性，HER2 阴性）、HER2 阳性（ER 和 PR 阳性或阴性，HER2 阳性）和三阴性（ER 阴性、PR 阴性和 HER2 阴性）-分别为白人、黑人、西班牙裔和亚裔女性。
luminal 乳腺癌亚型在不同种族/族裔群体中占主导地位，西班牙裔女性终生风险最低（4.60%，4.41-4.80%），白人女性最高（8.10%，7.94-8.20%）。HER2 阳性乳腺癌的种族差异较小（1.56-1.91%）。三阴性乳腺癌的终生风险在黑人女性中最高（1.98%，1.80-2.17%），而亚洲女性为 0.77%（0.67-0.88%），西班牙裔为 1.04%（0.96-1.13%），白人为 1.25%（1.20-1.30%）。在不同种族/族裔群体中，几乎一半的 luminal 乳腺癌发生在 70 岁以后。
这些绝对风险估计可能为不同人群的卫生政策和资源规划提供信息，并可以帮助患者和医生权衡发生特定乳腺癌亚型的概率与竞争健康风险。
