von Au Alexandra, Weiler Ulrike, Stefanovic Stefan, Wallwiener Markus, Heil Joerg, Golatta Michael, Rom Joachim, Sohn Christof, Schneeweiss Andreas, Schuetz Florian, Domschke Christoph
Department of Gynecology and Obstetrics, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany.
Arch Gynecol Obstet. 2016 Jul;294(1):145-52. doi: 10.1007/s00404-015-3938-0. Epub 2015 Nov 4.
The aim of this study was to identify differences between breast cancer patients with and without migrant background in Germany, especially differences concerning patient characteristics, tumor biology, diagnostics, therapy, and oncological outcome.
In 99 breast cancer patients (composed of 50 native, randomly selected Germans and 49 consecutively selected immigrants of Anatolian origin) who were operated due to breast cancer at the Heidelberg University Hospital between the years 2009-2012, relevant information was retrospectively reviewed.
Patients with migrant background were significantly younger at the time of receiving the diagnosis of breast cancer than native German patients with an average age difference of nine years (p < 0.001). Moreover, immigrants needed a second operation for re-excision more frequently than native Germans (45 vs. 20 %, p = 0.01). The medication used for hormone therapy was significantly different between the two cohorts (p = 0.049). Although statistically not significant, a tendency towards difference was observed in six characteristics examined: Premenopausal status, estrogen receptor-positive tumors, multifocal or bilateral tumors, BRCA-1 mutations, and an accompanying carcinoma in situ were more common in patients with migrant background. On the other hand, correspondence was found between both patient groups relating to tumor staging, grading and metastasis as well as surgical, drug, and radiologic therapies employed. Oncologic outcome data were not different either.
A difference in age between breast cancer patients of diverse ethnic groups has already been described previously. The difference in the frequency of surgical re-excision might be explained by several factors like a young age at first diagnosis, premenopausal status, multifocal tumors and an accompanying carcinoma in situ which were more common in the migrant patients of this study and are known to increase the risk of re-excision. The medication used for hormonal therapy was also different between migrants and native Germans, which might be interpreted by the difference in patients' age and menopausal status. Of note, however, in the present study, the overall breast cancer outcome did not show any substantial disparity between the different ethnic patient groups investigated.
本研究旨在明确德国有移民背景和无移民背景的乳腺癌患者之间的差异，尤其是在患者特征、肿瘤生物学、诊断、治疗及肿瘤学结局方面的差异。
回顾性分析了2009年至2012年间在海德堡大学医院因乳腺癌接受手术的99例患者（包括50名随机选取的德国本土患者和49名连续选取的安纳托利亚裔移民患者）的相关信息。
有移民背景的患者在确诊乳腺癌时显著比德国本土患者年轻，平均年龄差为9岁（p < 0.001）。此外，移民患者比德国本土患者更频繁地需要二次手术进行再次切除（45%对20%，p = 0.01）。两个队列之间用于激素治疗的药物存在显著差异（p = 0.049）。在所检查 的六个特征方面虽无统计学显著差异，但观察到有差异倾向：绝经前状态、雌激素受体阳性肿瘤、多灶性或双侧肿瘤、BRCA - 1突变以及伴发原位癌在有移民背景的患者中更为常见。另一方面，两组患者在肿瘤分期、分级和转移以及所采用的手术、药物和放射治疗方面存在一致性。肿瘤学结局数据也无差异。
此前已描述过不同种族乳腺癌患者之间的年龄差异。手术再次切除频率的差异可能由多种因素解释，如首次诊断时年龄较小、绝经前状态、多灶性肿瘤以及伴发原位癌，这些在本研究的移民患者中更为常见，且已知会增加再次切除的风险。移民和德国本土患者之间用于激素治疗的药物也不同，这可能由患者年龄和绝经状态的差异来解释。然而，值得注意的是，在本研究中，不同种族患者组之间的总体乳腺癌结局并未显示出任何实质性差异。
