Chen Lu, Li Christopher I
Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington. Department of Epidemiology, University of Washington, Seattle, Washington.
Cancer Epidemiol Biomarkers Prev. 2015 Nov;24(11):1666-72. doi: 10.1158/1055-9965.EPI-15-0293. Epub 2015 Oct 13.
African American and Hispanic women are more likely to be diagnosed with aggressive forms of breast cancer. Disparities within each subtype of breast cancer have not been well documented.
Using data from 18 SEER cancer registries, we identified 102,064 women aged 20 years or older, diagnosed with invasive breast cancer in 2010-2011, and with known stage, hormone receptor (HR), and HER2 status. Associations between race/ethnicity and cancer stage and receipt of guideline-concordant treatment were evaluated according to HR/HER2 status.
Overall, African American and Hispanic women were 30% to 60% more likely to be diagnosed with stage II-IV breast cancer compared with non-Hispanic whites. African American women had 40% to 70% higher risks of stage IV breast cancer across all four subtypes. American Indian/Alaska Native women had a 3.9-fold higher risk of stage IV triple-negative breast cancer. African American and Hispanic whites were 30% to 40% more likely to receive non-guideline-concordant treatment for breast cancer overall and across subtypes.
Women in several racial/ethnic groups are more likely to be diagnosed with more advanced stage breast cancer. African American and American Indian/Alaska Native women in particular had the highest risk of being diagnosed with stage IV triple-negative breast cancer. African American and Hispanic women were also consistently at higher risk of not receiving guideline-concordant treatment across subtypes.
These findings provide important characterization of which subtypes of breast cancer racial/ethnic disparities in stage and treatment persist.
非裔美国女性和西班牙裔女性更有可能被诊断出患有侵袭性乳腺癌。乳腺癌各亚型之间的差异尚未得到充分记录。
利用来自18个监测、流行病学和最终结果（SEER）癌症登记处的数据，我们确定了102,064名年龄在20岁及以上的女性，她们在2010 - 2011年被诊断为浸润性乳腺癌，且已知分期、激素受体（HR）和人表皮生长因子受体2（HER2）状态。根据HR/HER2状态评估种族/族裔与癌症分期以及接受符合指南治疗之间的关联。
总体而言，与非西班牙裔白人女性相比，非裔美国女性和西班牙裔女性被诊断为II - IV期乳腺癌的可能性高30%至60%。在所有四种亚型中，非裔美国女性患IV期乳腺癌的风险高40%至70%。美国印第安/阿拉斯加原住民女性患IV期三阴性乳腺癌的风险高3.9倍。非裔美国女性和西班牙裔白人女性总体上以及在各亚型中接受不符合指南的乳腺癌治疗的可能性高30%至40%。
几个种族/族裔群体的女性更有可能被诊断出患有更晚期的乳腺癌。特别是非裔美国女性和美国印第安/阿拉斯加原住民女性被诊断为IV期三阴性乳腺癌的风险最高。非裔美国女性和西班牙裔女性在各亚型中未接受符合指南治疗的风险也一直较高。
这些发现为乳腺癌在分期和治疗方面存在种族/族裔差异的哪些亚型提供了重要特征描述。
