Mariotto Angela B, Etzioni Ruth, Hurlbert Marc, Penberthy Lynne, Mayer Musa
Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland.
Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington.
Cancer Epidemiol Biomarkers Prev. 2017 Jun;26(6):809-815. doi: 10.1158/1055-9965.EPI-16-0889. Epub 2017 May 18.
Distant metastatic breast cancer (MBC), including metastases found at diagnosis () and those occurring later (recurrence), represents the most severe form of the disease, when resource utilization is most intensive. Yet, the number of women living with MBC in the United States is unknown. The objective of this article is to use population-based data to estimate the prevalence of MBC. We used a back-calculation method to estimate MBC prevalence from U.S. breast cancer mortality and survival from the Surveillance, Epidemiology and End Results (SEER) registries. On the basis of the illness-death process, this method assumes that each observed breast cancer death is the result of MBC, either or a recurrence with metastatic disease. We estimate that by January 1, 2017, there will be 154,794 women living with MBC in the United States, three in four initially diagnosed with stage I-III breast cancer who later progressed to MBC.Median survival and 5-year relative survival for MBC increased over the years, especially in younger women. We estimate a two-fold increase in 5-year relative survival rate from 18% to 36%, for women diagnosed with MBC at age 15-49 between 1992-1994 and 2005-2012, respectively. This study demonstrates an increasing number of women in the United States living with MBC, likely the result of improvements in treatment and aging of the U.S.
The increasing burden of MBC highlights the importance of documenting recurrence to foster more research into the specific needs of this understudied population. .
远处转移性乳腺癌（MBC），包括诊断时发现的转移灶（）以及后来出现的转移灶（复发），是疾病最严重的形式，此时资源利用最为密集。然而，美国MBC女性患者的数量尚不清楚。本文的目的是利用基于人群的数据来估计MBC的患病率。我们使用反向计算方法，根据美国监测、流行病学和最终结果（SEER）登记处的乳腺癌死亡率和生存率来估计MBC患病率。基于疾病-死亡过程，该方法假设每例观察到的乳腺癌死亡都是MBC的结果，无论是初诊时还是复发时伴有转移性疾病。我们估计，到2017年1月1日，美国将有154,794名MBC女性患者，其中四分之三最初被诊断为I-III期乳腺癌，后来进展为MBC。多年来，MBC的中位生存期和5年相对生存率有所提高，尤其是在年轻女性中。我们估计，1992 - 1994年和2005 - 2012年期间，年龄在15 - 49岁被诊断为MBC的女性，其5年相对生存率从18%提高到36%，增长了两倍。这项研究表明，美国MBC女性患者数量在增加，这可能是治疗改善和美国人口老龄化的结果。
MBC负担的增加凸显了记录复发情况以促进对这一研究不足人群的特定需求进行更多研究的重要性。
