Eng Lee Guek, Dawood Shaheenah, Sopik Victoria, Haaland Benjamin, Tan Pui San, Bhoo-Pathy Nirmala, Warner Ellen, Iqbal Javaid, Narod Steven A, Dent Rebecca
Department of Medical Oncology, National Cancer Center, 11 Hospital Drive, Singapore, 169690, Singapore.
Dubai Hospital, Dubai, United Arab Emirates.
Breast Cancer Res Treat. 2016 Nov;160(1):145-152. doi: 10.1007/s10549-016-3974-x. Epub 2016 Sep 14.
To evaluate breast cancer-specific survival at 10 years in patients who present with primary stage IV breast cancer, and to determine whether survival varies with age of diagnosis.
We retrieved the records of 25,323 women diagnosed with primary stage IV breast cancer in the surveillance, epidemiology, and end results 18 registries database from 1990 to 2012. For each case, we extracted information on age at diagnosis, tumour size, nodal status, oestrogen receptor status, progesterone receptor status, ethnicity, cause of death and date of death. The Cox proportional hazards model was used to estimate the unadjusted and adjusted hazard ratio (HR) of death due to stage IV breast cancer, according to age group.
Among 25,323 women with stage IV breast cancer, 2542 (10.0 %) were diagnosed at age 40 or below, 5562 (22.0 %) were diagnosed between ages 41 and 50 and 17,219 (68.0 %) were diagnosed between ages 51 and 70. After a mean follow-up of 2.2 years, 16,387 (64.7 %) women died of breast cancer (median survival 2.3 years). The ten-year actuarial breast cancer-specific survival rate was 15.7 % for women ages 40 and below, 14.9 % for women ages 41-50 and 11.7 % for women ages 51 to 70 (p < 0.0001). In an adjusted analysis, the risk of death from breast cancer at 10 years was significantly lower for women ages 40 and below (HR 0.78; 95 % CI 0.74-0.82; p < 0.0001) and for women ages 41-50 (HR 0.82; 95 % CI 0.79-0.85; p < 0.0001), compared to women ages 51-70.
Approximately 13 % of women with primary stage IV breast cancer survive 10 years after diagnosis. Women diagnosed with stage IV breast cancer before age 50 have better survival at 10 years compared to older women.
评估初诊为IV期乳腺癌患者的10年乳腺癌特异性生存率，并确定生存率是否随诊断年龄而变化。
我们从1990年至2012年的监测、流行病学和最终结果18个登记数据库中检索了25323例诊断为原发性IV期乳腺癌的女性记录。对于每例患者，我们提取了诊断时的年龄、肿瘤大小、淋巴结状态、雌激素受体状态、孕激素受体状态、种族、死亡原因和死亡日期等信息。采用Cox比例风险模型，根据年龄组估计IV期乳腺癌死亡的未调整和调整风险比（HR）。
在25323例IV期乳腺癌女性中，2542例（10.0%）在40岁及以下被诊断，5562例（22.0%）在41至50岁之间被诊断，17219例（68.0%）在51至70岁之间被诊断。平均随访2.2年后，16387例（64.7%）女性死于乳腺癌（中位生存期2.3年）。40岁及以下女性的10年精算乳腺癌特异性生存率为15.7%，41 - 50岁女性为14.9%，51至70岁女性为11.7%（p < 0.0001）。在调整分析中，40岁及以下女性（HR 0.78；95% CI 0.74 - 0.82；p < 0.0001）和41 - 50岁女性（HR 0.82；95% CI 0.79 - 0.85；p < 0.0001）10年死于乳腺癌的风险显著低于51 - 70岁女性。
约13%的原发性IV期乳腺癌女性在诊断后存活10年。与老年女性相比，50岁前诊断为IV期乳腺癌的女性10年生存率更高。
