Tagliabue Giovanna, Fabiano Sabrina, Contiero Paolo, Barigelletti Giulio, Castelli Maurizio, Mazzoleni Guido, Boschetti Lorenza, Fanetti Anna Clara, Puppo Antonella, Musolino Antonino, Cirilli Claudia, Seghini Pietro, Mangone Lucia, Caldarella Adele, Lotti Fernanda, Mazzucco Walter, Benedetto Andrea, Dinaro Ylenia Maria, Sferrazza Ausilia, Pinna Pasquala, Perotti Viviana
Cancer Registry Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, 20133 Milan, Italy.
Environmental Epidemiology Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, 20133 Milan, Italy.
J Clin Med. 2021 Dec 14;10(24):5873. doi: 10.3390/jcm10245873.
Breast cancer stage at diagnosis, patient age and molecular tumor subtype influence disease progression. The aim of this study was to analyze the relationships between these factors and survival in breast cancer patients among the Italian population using data from the AIRTUM national database. We enrolled women with primary breast cancer from 17 population-based cancer registries. Patients were subdivided into older (>69 years), middle (50-69 years) and younger age groups (<50 years) and their primary tumors categorized into four molecular subtypes based on hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status. There were 8831 patients diagnosed between 2010 and 2012 included. The most represented age group was 50-69 years (41.7%). In 5735 cases the molecular subtype was identified: HER2-/HR+ was the most frequent (66.2%) and HER2+/HR- the least (6.2%). Of the 390 women with metastases at diagnosis, 38% had simultaneous involvement of multiple sites, independent of age and molecular profile. In women with a single metastatic site, bone (20% of cases), liver (11%), lung (7%) and brain (3%) were the most frequent. In the studied age groups with different receptor expression profiles, the tumor metastasized to target organs with differing frequencies, affecting survival. Five-year survival was lowest in women with triple-negative (HER2-/HR-) tumors and women with brain metastases at diagnosis.
乳腺癌诊断时的分期、患者年龄和分子肿瘤亚型会影响疾病进展。本研究的目的是利用AIRTUM国家数据库的数据，分析意大利人群中乳腺癌患者的这些因素与生存之间的关系。我们纳入了来自17个基于人群的癌症登记处的原发性乳腺癌女性患者。患者被分为老年组（>69岁）、中年组（50 - 69岁）和青年组（<50岁），其原发性肿瘤根据激素受体（HR）和人表皮生长因子受体2（HER2）状态分为四种分子亚型。共纳入了2010年至2012年期间诊断的8831例患者。人数最多的年龄组是50 - 69岁（41.7%）。在5735例病例中确定了分子亚型：HER2 - /HR +最为常见（66.2%），HER2 + /HR -最少见（6.2%）。在诊断时已有转移的390例女性患者中，38%同时累及多个部位，与年龄和分子特征无关。在有单个转移部位的女性中，骨转移（占病例的20%）、肝转移（11%）、肺转移（7%）和脑转移（3%）最为常见。在具有不同受体表达谱的研究年龄组中，肿瘤转移到不同靶器官的频率不同，从而影响生存。三阴性（HER2 - /HR -）肿瘤患者和诊断时伴有脑转移的女性患者的五年生存率最低。
