Epidemiology of early vs late recurrence among women with early stage estrogen receptor-positive breast cancer in the Pathways Study.

IF 9.9 1区 医学 Q1 ONCOLOGY JNCI Journal of the National Cancer Institute Pub Date : 2024-10-01 DOI:10.1093/jnci/djae128
Alfredo V Chua, Haiyang Sheng, Emily Liang, Shipra Gandhi, Marilyn L Kwan, Isaac J Ergas, Janise M Roh, Cecile A Laurent, Li Yan, Thaer Khoury, Christine B Ambrosone, Lawrence H Kushi, Song Yao
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Abstract

Background: Relatively little is known about the differences in prognostic factors for early vs late recurrence among women with early stage estrogen receptor-positive breast cancer.

Methods: We analyzed factors related to early (<5 years) vs late (≥5 years) recurrence in 2992 women with stage I-IIB estrogen receptor-positive breast cancer in the Pathways Study, a prospective cohort of women with breast cancer enrolled between 2006 and 2013, with ascertainment of recurrence and death through December 2021.

Results: After a median follow-up of 13.3 years, 341 (13.8%) women had recurrences, including 181 (53.7%) with late recurrence. Higher stage and grade were associated with recurrence regardless of timing, whereas progesterone receptor negativity was associated with early but not late recurrence. Receipt of endocrine therapy was associated with reduced risk of overall recurrence, but the length of endocrine therapy was not statistically significant in multivariable models. Minoritized racial and ethnic groups, including Asian, Black, and Hispanic women, had higher risk of early but not late recurrence compared to non-Hispanic White women. The trend of higher risk of early recurrence among these groups remained after adjustment for clinical, demographic, and socioeconomic factors but was statistically significant only in Asian women.

Conclusions: Our study revealed potentially important distinctions for early vs late recurrence, including the associations with progesterone receptor negativity and self-identified race and ethnicity. Possible higher risk of early recurrence among Asian, Black, and Hispanic women provides novel evidence for the existence of disparities in cancer outcomes, even within the breast cancer subtype indicative of generally good prognosis.

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路径研究中早期雌激素受体阳性乳腺癌妇女早期与晚期复发的流行病学。
背景:在早期雌激素受体阳性(ER+)乳腺癌患者中,早期复发与晚期复发的预后因素存在差异:人们对早期雌激素受体阳性(ER+)乳腺癌女性患者早期复发与晚期复发的预后因素差异知之甚少:我们分析了与早期复发相关的因素:中位随访 13.3 年后,341 名(13.8%)妇女复发,其中 181 名(53.7%)晚期复发。无论何时复发,较高的分期和分级都与复发有关,而孕酮受体(PR)阴性与早期复发有关,但与晚期复发无关。接受内分泌治疗与总体复发风险的降低有关,但内分泌治疗的时间长短在多变量模型中并不显著。与非西班牙裔白人妇女相比,少数种族和民族群体(包括亚裔、黑人和西班牙裔妇女)的早期复发风险较高,但晚期复发风险并不高。在对临床、人口统计学和社会经济因素进行调整后,这些群体中早期复发风险较高的趋势依然存在,但只有亚裔妇女的这一趋势具有统计学意义:我们的研究揭示了早期复发与晚期复发之间潜在的重要区别,包括与 PR 阴性及自我认同的种族和民族的关联。亚裔、黑人和西班牙裔妇女早期复发的风险可能较高,这为癌症结果存在差异提供了新的证据,即使在预后普遍良好的乳腺癌亚型中也是如此。
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来源期刊
CiteScore
17.00
自引率
2.90%
发文量
203
审稿时长
4-8 weeks
期刊介绍: The Journal of the National Cancer Institute is a reputable publication that undergoes a peer-review process. It is available in both print (ISSN: 0027-8874) and online (ISSN: 1460-2105) formats, with 12 issues released annually. The journal's primary aim is to disseminate innovative and important discoveries in the field of cancer research, with specific emphasis on clinical, epidemiologic, behavioral, and health outcomes studies. Authors are encouraged to submit reviews, minireviews, and commentaries. The journal ensures that submitted manuscripts undergo a rigorous and expedited review to publish scientifically and medically significant findings in a timely manner.
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