King's College London, Thames Cancer Registry, 1st Floor Capital House, 42 Weston Street, London SE1 3QD, United Kingdom.
Eur J Cancer. 2013 Feb;49(3):696-702. doi: 10.1016/j.ejca.2012.09.012. Epub 2012 Oct 8.
Triple negative breast cancer (TNBC) is associated with different ethnic groups in the United States (US), however this has not previously been examined in a population-based study within the United Kingdom (UK).
Electronic pathology reports from the North East London Cancer Network (NELCN) on women diagnosed with breast cancer between 2005 and 2007 were collated. The statuses of oestrogen receptor, progesterone receptor and HER-2 were extracted. Women were classified as having TNBC if all three receptor statuses were negative, and as not having TNBC if at least one receptor was positive or borderline. Logistic regression was used to quantify the association between TNBC and ethnicity, adjusting for age, year of diagnosis and socioeconomic deprivation. Overall survival in different ethnic groups was examined using Cox regression, adjusting as appropriate for age, stage of disease, triple negative status, year of diagnosis, socioeconomic deprivation and recorded treatment.
There were 2417 women resident in NELCN diagnosed with breast cancer between 2005 and 2007, and TNBC status was determined for 1228 (51%) women. Overall, of women who had their TNBC status determined, 128 (10%) were diagnosed with TNBC. Compared with White women, Black (odds ratio [OR]=2.81, p<0.001) and South Asian (OR=1.80, p=0.044) women with breast cancer were more likely to have TNBC. Black women had a worse age-adjusted survival than White women (hazard ratio [HR]=2.05, p<0.001). This was attenuated by further adjustment for stage of disease (1.52, p=0.032) and triple negative status (1.31, p=0.175).
Better methods of early detection may need to be developed in addition to more effective systemic treatment in order to improve outcomes for women with TNBC.
三阴性乳腺癌（TNBC）在美国的不同种族中存在差异，但在英国的基于人群的研究中尚未对此进行过研究。
收集了 2005 年至 2007 年间在东安格利亚癌症网络（NELCN）诊断为乳腺癌的女性的电子病理报告。提取雌激素受体、孕激素受体和 HER-2 的状态。如果所有三种受体状态均为阴性，则将女性归类为 TNBC，如果至少有一种受体为阳性或边界，则归类为非 TNBC。使用逻辑回归来量化 TNBC 与种族之间的关联，同时调整年龄、诊断年份和社会经济贫困程度。使用 Cox 回归检查不同种族的总生存率，适当调整年龄、疾病分期、三阴性状态、诊断年份、社会经济贫困和记录的治疗。
在 NELCN 居住的 2417 名女性被诊断患有乳腺癌，2005 年至 2007 年期间，1228 名（51%）女性的 TNBC 状态得到确定。总的来说，在确定 TNBC 状态的女性中，有 128 名（10%）被诊断为 TNBC。与白人女性相比，患有乳腺癌的黑人（优势比[OR]=2.81，p<0.001）和南亚人（OR=1.80，p=0.044）更有可能患有 TNBC。黑人女性的年龄调整后生存率比白人女性差（风险比[HR]=2.05，p<0.001）。通过进一步调整疾病分期（1.52，p=0.032）和三阴性状态（1.31，p=0.175），这一结果有所减弱。
为了改善 TNBC 女性的结局，可能需要开发更好的早期检测方法，以及更有效的系统治疗。
