Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, China.
Health Management Center of University-Town Hospital Affiliated to Chongqing Medical University, Chongqing, China.
Sci Rep. 2024 Oct 10;14(1):23690. doi: 10.1038/s41598-024-74746-1.
Hormone receptor-positive breast cancer (BC) is the most prevalent subtype of BC and is generally correlated with a favorable prognosis. This study aimed to determine the incidence and survival trends among women diagnosed with hormone receptor-positive BC between 1990 and 2019. Female patients with hormone receptor-positive BC for calendar years 1990-2019 were obtained from the Surveillance, Epidemiology, and End Results (SEER) database and categorized into six diagnostic groups according to the year of diagnosis. Age-adjusted incidence rates (IRs) were calculated using joinpoint regression. We used the Kaplan-Meier method and multivariate Cox regression analyses to determine the association between diagnostic groups, and overall survival (OS) and BC-specific survival (BCSS). The final analysis included 370,729 women, among whom 37,943 (10.2%), 49,266 (13.3%), 55,652 (15.0%), 64,451 (17.4%), 77,127 (20.8%), and 86,290 (23.3%) were diagnosed between 1990 and 1994, 1995-1999, 2000-2004, 2005-2009, 2010-2014, and 2015-2019, respectively. Within the overall cohort, IRs gradually increased from 70 per 100,000 in 1990 to 113 per 100,000 in 2019 (average annual percent change, 1.59%; 95% CI, 1.18-1.99). Multivariate Cox regression analysis revealed that the survival outcomes gradually improved over nearly three decades among hormone receptor-positive BC patients, with a 0.8% and 1.3% decrease in risk for all-cause and BC-specific mortality each year, respectively. Compared to 1990-1994, hormone receptor-positive BC patients diagnosed in 2015-2019 had a 22% lower risk of all-cause death (hazard ratio [HR], 0.78; 95% CI, 0.76-0.81) and a 27% lower risk of BC-specific death (HR, 0.73; 95% CI, 0.70-0.76). The development of treatment strategies within the past three decades, especially endocrine therapy, may contribute to the continuous improvement of clinical outcomes in patients with hormone receptor-positive BC.
激素受体阳性乳腺癌（BC）是最常见的乳腺癌亚型，通常与良好的预后相关。本研究旨在确定 1990 年至 2019 年间诊断为激素受体阳性 BC 的女性患者的发病率和生存趋势。从监测、流行病学和最终结果（SEER）数据库中获取 1990-2019 年日历年度激素受体阳性 BC 的女性患者，并根据诊断年份分为六个诊断组。使用 joinpoint 回归计算年龄调整发病率（IR）。我们使用 Kaplan-Meier 方法和多变量 Cox 回归分析来确定诊断组与总生存（OS）和乳腺癌特异性生存（BCSS）之间的关联。最终分析包括 370729 名女性，其中 37943（10.2%）、49266（13.3%）、55652（15.0%）、64451（17.4%）、77127（20.8%）和 86290（23.3%）分别于 1990 年至 1994 年、1995 年至 1999 年、2000 年至 2004 年、2005 年至 2009 年、2010 年至 2014 年和 2015 年至 2019 年诊断。在整个队列中，IR 从 1990 年的每 100,000 人 70 例逐渐增加到 2019 年的每 100,000 人 113 例（平均年变化百分比，1.59%；95%CI，1.18-1.99）。多变量 Cox 回归分析显示，近三十年来，激素受体阳性 BC 患者的生存结果逐渐改善，全因和乳腺癌特异性死亡率的风险每年分别降低 0.8%和 1.3%。与 1990-1994 年相比，2015-2019 年诊断为激素受体阳性 BC 的患者全因死亡风险降低 22%（风险比[HR]，0.78；95%CI，0.76-0.81），乳腺癌特异性死亡风险降低 27%（HR，0.73；95%CI，0.70-0.76）。在过去三十年中治疗策略的发展，特别是内分泌治疗，可能有助于改善激素受体阳性 BC 患者的临床结局。
