Lim David W, Giannakeas Vasily, Narod Steven A
Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
JCO Glob Oncol. 2020 Oct;6:1582-1592. doi: 10.1200/GO.20.00316.
The affect of race on breast cancer prognosis is not well understood. We compared crude and adjusted breast cancer survival rates of Chinese women versus White women in the United States.
We conducted a cohort study of Chinese and White women with breast cancer diagnosed between 2004 to 2015 in the SEER 18 registries database. We abstracted information on age at diagnosis, tumor size, grade, lymph node status, receptor status, surgical treatment, receipt of radiotherapy and chemotherapy, and death. We compared crude breast cancer-specific mortality between the two ethnic groups. We calculated adjusted hazard ratios (HRs) in a propensity-matched design using the Cox proportional hazards model. < .05 was considered statistically significant.
There were 7,553 Chinese women (1.8%) and 414,618 White women (98.2%) with stage I-IV breast cancer in the SEER database. There were small differences in demographics, nodal burden, and clinical stage between Chinese and White women. Ten-year breast cancer-specific survival was 88.8% for Chinese women and 85.6% for White women (HR, 0.73; 95% CI, 0.67 to 0.80; < .0001). In a propensity-matched analysis among women with stage I-IIIC breast cancer, the HR was 0.71 (95% CI, 0.62 to 0.81; < .0001). Annual mortality rates in White women exceeded those in Chinese women for the first 9 years after diagnosis.
Chinese women in the United States have superior breast cancer-specific survival compared with White women. The reason for the observed difference is not clear. Differences in demographic and tumor features between Chinese and White women with breast cancer may contribute to the disparity, as may the possibility of intrinsic biologic differences.
种族对乳腺癌预后的影响尚未得到充分理解。我们比较了美国华裔女性与白人女性的乳腺癌粗生存率和调整后生存率。
我们对2004年至2015年在监测、流行病学和最终结果（SEER）18登记处数据库中诊断为乳腺癌的华裔和白人女性进行了一项队列研究。我们提取了诊断时的年龄、肿瘤大小、分级、淋巴结状态、受体状态、手术治疗、放疗和化疗的接受情况以及死亡信息。我们比较了两个种族之间的乳腺癌特异性粗死亡率。我们使用Cox比例风险模型在倾向匹配设计中计算调整后的风险比（HR）。P <.05被认为具有统计学意义。
SEER数据库中有7553名华裔女性（1.8%）和414618名白人女性（98.2%）患有I-IV期乳腺癌。华裔和白人女性在人口统计学、淋巴结负担和临床分期方面存在微小差异。华裔女性的10年乳腺癌特异性生存率为88.8%，白人女性为85.6%（HR，0.73；95%CI，0.67至0.80；P <.0001）。在I-IIIC期乳腺癌女性的倾向匹配分析中，HR为0.71（95%CI，0.62至0.81；P <.0001）。在诊断后的前9年，白人女性的年死亡率超过华裔女性。
美国华裔女性的乳腺癌特异性生存率高于白人女性。观察到的差异原因尚不清楚。患有乳腺癌的华裔和白人女性在人口统计学和肿瘤特征方面的差异可能导致了这种差异，内在生物学差异的可能性也可能如此。
