美国女性 1992-2016 年期间，基于首次乳腺癌特征的对侧乳腺癌风险。
Risk of contralateral breast cancer according to first breast cancer characteristics among women in the USA, 1992-2016.
机构信息
Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
Integrative Tumor Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
出版信息
Breast Cancer Res. 2021 Feb 17;23(1):24. doi: 10.1186/s13058-021-01400-3.
BACKGROUND
Estimates of contralateral breast cancer (CBC) risk in the modern treatment era by year of diagnosis and characteristics of the first breast cancer are needed to assess the impact of recent advances in breast cancer treatment and inform clinical decision making.
METHODS
We examined CBC risk among 419,818 women (age 30-84 years) who were diagnosed with a first unilateral invasive breast cancer and survived ≥ 1 year in the US Surveillance, Epidemiology, and End Results program cancer registries from 1992 to 2015 (follow-up through 2016). CBC was defined as a second invasive breast cancer in the contralateral breast ≥ 12 months after the first breast cancer. We estimated standardized incidence ratios (SIRs) of CBC by year of diagnosis, age at diagnosis, and tumor characteristics for the first breast cancer. Cumulative incidence of CBC was calculated for women diagnosed with a first breast cancer in the recent treatment era (2004-2015, follow-up through 2016).
RESULTS
Over a median follow-up of 8 years (range 1-25 years), 12,986 breast cancer patients developed CBC. Overall, breast cancer patients had approximately twice the risk of developing cancer in the contralateral breast when compared to that expected in the general population (SIR = 2.21, 95% CI = 2.17-2.25). SIRs for CBC declined by year of first diagnosis, irrespective of age at diagnosis and estrogen receptor (ER) status (p-trends < 0.001), but the strongest decline was after an ER-positive tumor. The 5-year cumulative incidence of CBC ranged from 1.01% (95% CI = 0.90-1.14%) in younger women (age < 50 years) with a first ER-positive tumor to 1.89% (95% CI = 1.61-2.21%) in younger women with a first ER-negative tumor.
CONCLUSION
Declines in CBC risk are consistent with continued advances in breast cancer treatment. The updated estimates of cumulative incidence inform breast cancer patients and clinicians on the risk of CBC and may help guide treatment decisions.
背景
需要根据诊断年份和首次乳腺癌的特征来估计现代治疗时代的对侧乳腺癌（CBC）风险，以评估乳腺癌治疗的最新进展的影响并为临床决策提供信息。
方法
我们研究了 419818 名（30-84 岁）女性的 CBC 风险，这些女性在美国监测、流行病学和最终结果（SEER）癌症登记处被诊断为单侧浸润性乳腺癌且生存时间≥1 年，随访至 2016 年（截至 2016 年）。CBC 定义为首次乳腺癌后≥12 个月在对侧乳房中发生的第二例浸润性乳腺癌。我们根据首次乳腺癌的诊断年份、诊断时的年龄和肿瘤特征来估计 CBC 的标准化发病比（SIR）。计算了在最近治疗时代（2004-2015 年，随访至 2016 年）诊断为首次乳腺癌的女性的 CBC 累积发生率。
结果
在中位随访 8 年（范围 1-25 年）期间，有 12986 名乳腺癌患者发生 CBC。总体而言，与一般人群相比，乳腺癌患者发生对侧乳腺癌的风险约为两倍（SIR=2.21，95%CI=2.17-2.25）。不论诊断时的年龄和雌激素受体（ER）状态如何，首次诊断的年份与 CBC 的 SIR 呈下降趋势（趋势 P 值<0.001），但最强的下降发生在 ER 阳性肿瘤之后。5 年的 CBC 累积发生率范围从年轻女性（年龄<50 岁）的 1.01%（95%CI=0.90-1.14%），到年轻女性的 1.89%（95%CI=1.61-2.21%），首次诊断为 ER 阴性肿瘤。
结论
CBC 风险的下降与乳腺癌治疗的持续进展一致。更新的累积发生率估计值为乳腺癌患者和临床医生提供了关于 CBC 风险的信息，并可能有助于指导治疗决策。
Zotero 插件