scholarly journals Racial Disparities in the Incidence, Breast Conserving Rate and Survival of Breast Cancer Patients Who Underwent Breast Conserving Surgery

2021 ◽  
Author(s):  
Shu Han ◽  
Jianjun Liu ◽  
Weifang Tang ◽  
Shengying Wang ◽  
Shikai Hong
Keyword(s):  
Breast Cancer ◽  
Racial Disparities ◽  
Cancer Incidence ◽  
White Women ◽  
Breast Cancer Incidence ◽  
Relative Survival ◽  
Breast Conserving Surgery ◽  
Incidence Rates ◽  
Breast Cancer Patients ◽  
Cancer Specific Survival

Abstract Objective: In the current study, we aimed to provide a clear insight on the racial disparity of breast conserving rate (BCR) and survival in breast cancer after breast conserving surgery (BCS). Materials and Methods: Using data from the Surveillance, Epidemiology, and End Results program (SEER), we estimated breast cancer incidence rates and the rate of BCS by race in two periods (2000-2004 and 2013-2017). Relative survival analysis was based on patient-level data from 1998 to 2017. To be adjusted for baseline differences for different races, inverse probability weighting (IPW) models were stepwise performed.Results: From 2000-2004 to 2013-2017, both the breast cancer incidence (from 4.18 to 5.05 per 1000 white women) and the proportion of patients after BCS (from 55.5% to 59.9) were highest in whites than that of other races. Black individuals’ incidence (1.20 per 1000 black women or relatives 43.6% increased) and the BCR were increased most rapidly (6%) than other races. Asian or Pacific Islanders (APIs) were less likely to be diagnosed at a later stage and had the best prognosis than those of other races. After baselines fully adjusted, whites had the better Breast Cancer Specific Survival (BCSS) and Overall Survival (OS) than that of minorities (all p< 0.001).Conclusions: We identified the racial disparities of breast cancer incidence, BCR, and survival differences. We found increase trends of breast cancer incidence and BCR in minorities; however, we also identified the worse survival of minorities than that of whites, regardless of age, tumor stage, grade, and Luminal subtype.

Risk-based recommendations for mammographic screening for women in their forties.

1998 ◽  
Vol 16 (9) ◽  
pp. 3105-3114 ◽  
Author(s):  
M Gail ◽  
B Rimer
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Black Women ◽  
Cancer Incidence ◽  
White Women ◽  
Present Report ◽  
Breast Cancer Incidence ◽  
Mammographic Screening ◽  
Incidence Rates ◽  
Flow Diagram

PURPOSE To develop risk-based recommendations for mammographic screening for women in their 40s that take into account the woman's age, race, and specific risk factors. METHODS We assumed that regular mammographic screening is justified for a 50-year-old woman, even one with no risk factors, and that a younger woman with an expected 1-year breast cancer incidence rate as great or greater than that of a 50-year-old woman with no risk factors would benefit sufficiently to justify regular screening. Recommendations under this criterion were based on age- and race-specific breast cancer incidence rates from the National Cancer Institute's (NCI's) Surveillance, Epidemiology, and End Results (SEER) Program; assessments of risk factors from the Breast Cancer Detection and Demonstration Project (BCDDP); and reports in the literature. RESULTS Two methods, the exact-age procedure (EAP) and the grouped-age procedure (GAP), were developed. The less precise GAP only requires following a flow diagram. The proportion of white women recommended for screening by the EAP ranges from 10% for 40-year-old women to 95% for 49-year-old women, and the corresponding percentages for black women are 16% and 95%. The assumptions that underlie the guidelines are discussed critically. CONCLUSION For women or physicians who prefer an individualized approach in deciding whether to initiate regular mammographic screening in the age range of 40 to 49 years, the present report offers recommendations based on individualized risk-factor data and clearly stated assumptions that have an empiric basis. These recommendations can be used to facilitate the counseling process.

scholarly journals Recent trends in breast cancer incidence in US white women by county-level urban/rural and poverty status

BMC Medicine ◽  
2009 ◽  
Vol 7 (1) ◽  
Author(s):  
Amelia K Hausauer ◽  
Theresa HM Keegan ◽  
Ellen T Chang ◽  
Sally L Glaser ◽  
Holly Howe ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Incidence ◽  
White Women ◽  
Breast Cancer Incidence ◽  
County Level ◽  
Poverty Status ◽  
Urban Rural ◽  
Recent Trends

scholarly journals Historical Trends in Incidence of Breast Cancer in Shanghai, Hong Kong and Los Angeles, 1973–2012: A Joinpoint and Age-Period-Cohort Analysis

2021 ◽  
Vol 66 ◽  
Author(s):  
Hang-Hang Luan ◽  
Li-Sha Luo ◽  
Zhi-Yan Lu
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Hong Kong ◽  
Los Angeles ◽  
Cancer Incidence ◽  
White Women ◽  
Cohort Analysis ◽  
Breast Cancer Incidence ◽  
Cohort Effects ◽  
Period Effect

Objectives: This study aimed to estimate the long-term trends of breast cancer incidence in Shanghai, Hong Kong, and Los Angeles (LA).Methods: Data were obtained from Cancer Incidence in Five Continents (CI5plus) database. The average annual percent change (AAPC) was conducted by joinpoint regression analysis, and the age, period and cohort effects were estimated by age-period-cohort (APC) analysis.Results: The age-standardized incidence rates (ASIRs) in LA were higher than Shanghai and Hong Kong. During 1988–2012, the ASIRs significantly decreased in white women in LA (AAPC = −0.6%, 95% CI: −0.9% to −0.4%) while increased in Shanghai (2.5%: 2.1%–2.9%) and Hong Kong (2.2%: 2.0%–2.5%). The APC analysis revealed significantly increased effects of age and period, and decreased effect of birth cohort.Conclusion: Although age and cohort effects were relatively strong, the period effect may be the key factor affecting trends of incidence, which may be caused by increasing exposures to carcinogens and risk factors. Therefore, more effective measures should be carried out promptly to protect high-risk populations such as elder women, to avoid exposures to risk factors of breast cancer.

Incidence of Invasive Breast Cancer by Hormone Receptor Status From 1992 to 1998

2003 ◽  
Vol 21 (1) ◽  
pp. 28-34 ◽  
Author(s):  
Christopher I. Li ◽  
Janet R. Daling ◽  
Kathleen E. Malone
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Cancer Incidence ◽  
Hormone Receptor ◽  
Breast Cancer Incidence ◽  
The United States ◽  
Incidence Rates ◽  
Hormone Receptor Status ◽  
Receptor Status ◽  
Cancer Incidence Rates

Purpose: Between 1987 and 1998, breast cancer incidence rates rose 0.5%/yr in the United States. A question of potential etiologic and clinical importance is whether the hormone receptor status of breast tumors is also changing over time. This is because hormone receptor status may reflect different etiologic pathways and is useful in predicting response to adjuvant therapy and prognosis. Methods: Age-adjusted, age-specific breast cancer incidence rates by estrogen receptor (ER) and progesterone receptor (PR) status from 1992 to 1998 were obtained and compared from 11 population-based cancer registries in the United States that participate in the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program. Results: From 1992 to1998, the overall proportion of breast cancers that were ER-positive and PR-positive increased from 75.4% to 77.5% (P = .0002) and from 65.0% to 67.7% (P < .0001), respectively, continuing trends observed before 1992. These increases were limited to women 40 to 69 years of age. The proportions of ER-positive/PR-positive tumors increased from 56.7% to 62.3% (P = .0010) among 40- to 49-year-olds, from 58.0% to 63.2% (P = .0002) among 50- to 59-year-olds, and from 63.2% to 67.9% (P = .0020) among 60- to 69-year-olds. Conclusion: From 1992 to 1998, the proportion of tumors that are hormone receptor–positive rose as the proportion of hormone receptor–negative tumors declined. Because the incidence rates of hormone receptor–negative tumors remained fairly constant over these years, the overall rise in breast cancer incidence rates in the United States seems to be primarily a result of the increase in the incidence of hormone receptor–positive tumors. Hormonal factors may account for this trend.

scholarly journals Increase in Distant Stage Breast Cancer Incidence Rates in US Women Aged 25–49 Years, 2000–2011: The Stage Migration Hypothesis

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Anthony P. Polednak
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Incidence ◽  
Relative Survival ◽  
Distant Metastases ◽  
Incidence Rates ◽  
Stage Migration ◽  
Relative Survival Rate ◽  
Regional Stage ◽  
Er Positive ◽  
Using Data

Background.Unexplained increases have been reported in incidence rates for breast cancer diagnosed at distant stage in younger U.S. women, using data from the Surveillance, Epidemiology and End Results (SEER) Program.Methods.This report focused on recent SEER trends (2000–2011) in age-standardized incidence rates of invasive breast cancer at ages 25–39 and 40–49 years and the hypothesis that stage migration may have resulted from advances in detecting distant metastases at diagnosis.Results.Increases in the rates for distant stage were roughly equal to decreases in the rates for the most advanced stage subgroups within regional stage; this was evident for estrogen receptor (ER) negative cancers, associated with poorer prognosis, but not for ER positive cancers. The 3-year relative survival rate increased over time for distant stage (especially in the ER positive subgroup) and regional stage but not for localized stage; these trends do not contradict the stage-migration hypothesis.Conclusions.Findings provide some support for stage migration as one explanation for the recent increase in incidence of distant stage breast cancer, but additional studies are needed using other databases.

Stage migration in breast cancer: Better detection or semantics in staging?

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18800-e18800
Author(s):  
Leah Elson ◽  
Nadeem Bilani ◽  
Hong Liang ◽  
Elizabeth Blessing Elimimian ◽  
Diana Saravia ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Incidence ◽  
Late Stage ◽  
Early Stage ◽  
Breast Cancer Incidence ◽  
Incidence Rates ◽  
Information Criteria ◽  
Stage Migration ◽  
Cancer Data ◽  
Best Fit

e18800 Background: As oncology treatment has evolved to become more individualized, prognostic rationale has also undergone important changes. In breast cancer, disease staging was historically based upon anatomic features of the primary tumor, in combination with involvement of adjacent/distant tissues. However, as the understanding of molecular/genomic involvement became more advanced, staging definitions were redefined to incorporate receptors, histologic grade, and genetic expression. In this analysis, we use autoregressive integrated moving average (ARIMA) forecasting to understand how AJCC updates to prognostic definitions have contributed to stage migration, and to comment on whether better detection, or definitional changes, may be responsible for the increasing incidence in early stage breast cancer. Methods: In this time series forecast, ARIMA models, per stage (early: stage I/II vs. late: stage III/IV) were constructed based on 2004-2016 historic breast cancer incidence rates, as reported by the NCDB. Multiple models were generated, using differing autoregressive parameters; the most predictive model was chosen using the lowest Bayesian Information Criteria (BIC), and mean absolute percentage error (MAPE) to ensure best fit. Similar methodology has already been published to predict prostate cancer incidence. The best fit models were applied to forecast annual incidence, in the NCDB, in 2017. These data were compared to the real-world data captured in 2017. Statistics were performed using modeling systems in SPSS, version 27. Results: n=1,661,971 cases were included for these models, and 12 years of pre-AJCC updated NCDB breast cancer data were used. Using ARIMA modeling, best fit, stationary averages were identified, with autoregressive and difference terms which contributed to the lowest BIC, and MAPE < 5%, for both models. The best fit models forecasted 2017 incidence, by stage, without AJCC updates to staging criteria, and this data is compared to actual 2017 incidence with current updated AJCC 8th staging criteria (Table). Conclusions: During 2017, the first year of AJCC staging updates, there was an observed decrease in late stage diagnoses, and increase in early stage diagnoses, when compared with incidence rates that were forecasted using the old, anatomic AJCC criteria. Therefore, part of the stage migration noted may be a product of staging semantics, using updated definitions. Confirming appropriate improvement in long-term outcomes, based on new staging would be helpful. It is also important for clinicians and public health officials to bear this in-mind when interpreting epidemiologic data, for allocating resources, as shifts in staging may be a product of guideline changes, and not necessarily screening efficacy or early detection only.[Table: see text]

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