Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, Georgia.
Department of Health Management and Policy, School of Public Health, Georgia State University, Atlanta, Georgia.
Cancer. 2019 Oct 1;125(19):3412-3417. doi: 10.1002/cncr.32207. Epub 2019 Jul 8.
BACKGROUND: Triple-negative breast cancer (TNBC) has been associated with a more aggressive histology, poorer prognosis, and nonresponsiveness to hormone therapy. It is imperative that cancer research identify factors that drive disparities and focus on prevention. METHODS: Using the United States Cancer Statistics database, the authors examined differences between TNBCs compared with all other breast cancers with regard to age, race/ethnicity, and stage at diagnosis. RESULTS: A total of 1,151,724 cases of breast cancer were identified from 2010 through 2014, with the triple-negative phenotype accounting for approximately 8.4% of all cases. In unadjusted analyses, non-Hispanic black women (odds ratio [OR], 2.27; 95% CI, 2.23-2.31) and Hispanic women (OR, 1.22; 95% CI, 1.19-1.25) had higher odds of diagnosis when compared with non-Hispanic white women. Women aged <40 years had the highest odds of diagnosis compared with women aged 50 to 64 years (OR, 1.95; 95% CI, 1.90-2.01). Diagnosis at American Joint Committee on Cancer stage III and beyond conferred higher odds of the diagnosis of TNBC (OR for stage III, 1.69 [95% CI, 1.68-1.72]; and OR for stage IV, 1.47 [95% CI, 1.43-1.51]). Results varied slightly in adjusted analyses. CONCLUSIONS: The results of the current study demonstrated that there is a significant burden of disease in TNBC diagnosed among women of color, specifically non-Hispanic black women, and younger women. Additional studies are needed to determine drivers of disparities between race, age, and stage of disease at diagnosis.
背景:三阴性乳腺癌(TNBC)与更具侵袭性的组织学、更差的预后和对激素治疗无反应有关。癌症研究必须确定导致差异的因素,并专注于预防。
方法:作者使用美国癌症统计数据库,检查了 2010 年至 2014 年期间 TNBC 与所有其他乳腺癌在年龄、种族/族裔和诊断时的分期方面的差异。
结果:共确定了 1151724 例乳腺癌病例,其中三阴性表型约占所有病例的 8.4%。在未调整分析中,与非西班牙裔白人女性相比,非西班牙裔黑人女性(比值比[OR],2.27;95%置信区间[CI],2.23-2.31)和西班牙裔女性(OR,1.22;95%CI,1.19-1.25)诊断的可能性更高。与 50 至 64 岁的女性相比,年龄<40 岁的女性诊断的可能性最高(OR,1.95;95%CI,1.90-2.01)。美国癌症联合委员会(AJCC)分期 III 期及以上的诊断与 TNBC 诊断的可能性更高相关(分期 III 期的 OR,1.69[95%CI,1.68-1.72];分期 IV 期的 OR,1.47[95%CI,1.43-1.51])。调整分析后的结果略有不同。
结论:本研究的结果表明,有色人种(尤其是非西班牙裔黑人女性)和年轻女性中 TNBC 的疾病负担显著。需要进一步的研究来确定种族、年龄和诊断时疾病分期之间差异的驱动因素。
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