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Mortality rates among early-stage hormone receptor-positive breast cancer patients: a population-based cohort study in Denmark.
J Natl Cancer Inst 2011; 103(18):1363-72JNCI

Abstract

BACKGROUND

Indications for adjuvant endocrine treatment of breast cancer have gradually increased over the past several years. We aimed to define subgroups of patients who may or may not benefit from adjuvant endocrine therapy.

METHODS

A population-based cohort of systemically untreated breast cancer patients (N = 3197) were identified within the registry of the Danish Breast Cancer Cooperative Group (DBCG). The patients were node negative and had estrogen receptor-positive and/or progesterone receptor-positive tumors (except medullary tumors) and were further characterized by the following risk factors: aged 35-74 years (grouped into 5-year categories) at surgery, tumor size (≤20 mm), and histopathology (grade 1 ductal carcinoma, grade 1 or 2 invasive lobular carcinoma, other or unknown histopathology). Standardized mortality ratios (SMRs) were calculated based on the mortality rate (observed number of deaths per 100,000 person-years) among patients relative to the mortality rate in the general population of women (expected number of deaths per 100,000 person-years). The association between standardized mortality ratio and risk factors were analyzed in univariate and multivariable Poisson regression models. All findings were validated in a subsequent DBCG cohort of breast cancer patients (N = 2710).

RESULTS

The median follow-up after surgery was 14.8 years. In the study population there were 970 deaths compared with expected death of 737 women, which was an excess mortality of 233 deaths (SMR = 1.32, 95% CI = 1.24 to 1.40). Mortality rates were 2356 per 100,000 person-years in the study population and 1790 per 100,000 person-years in the general population of women. The mortality rate was associated with larger tumor size (11-20 mm tumors vs 1-10 mm tumors, SMR = 1.42, 95% confidence interval [CI] = 1.31 to 1.53 vs. SMR = 1.12, 95% CI = 1.00 to 1.26). The mortality rate was also associated with age (35-59 years, SMR > 1) compared with that in the general population of age-matched women, except for a small subgroup of patients (aged 60-74 years, tumors ≤10 mm, grade 1 ductal carcinoma, and grade 1 or 2 lobular carcinoma: adjusted relative risk = 1.02, 95% CI = 0.89 to 1.16.).

CONCLUSIONS

A small subgroup of breast cancer patients who were 60 years or older and had hormone-responsive early-stage tumors up to 10 mm, and received no systemic adjuvant therapy, were not at increased risk of mortality compared with women in this age-group in the general population.

Authors+Show Affiliations

Breast and Endocrine Section, Department of Surgery P, Aarhus Sygehus, Aarhus University Hospital, Tage-Hansens Gade 2, DK-8000, Aarhus C, Denmark. peerchri@rm.dkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21881042

Citation

Christiansen, Peer, et al. "Mortality Rates Among Early-stage Hormone Receptor-positive Breast Cancer Patients: a Population-based Cohort Study in Denmark." Journal of the National Cancer Institute, vol. 103, no. 18, 2011, pp. 1363-72.
Christiansen P, Bjerre K, Ejlertsen B, et al. Mortality rates among early-stage hormone receptor-positive breast cancer patients: a population-based cohort study in Denmark. J Natl Cancer Inst. 2011;103(18):1363-72.
Christiansen, P., Bjerre, K., Ejlertsen, B., Jensen, M. B., Rasmussen, B. B., Lænkholm, A. V., ... Mouridsen, H. T. (2011). Mortality rates among early-stage hormone receptor-positive breast cancer patients: a population-based cohort study in Denmark. Journal of the National Cancer Institute, 103(18), pp. 1363-72. doi:10.1093/jnci/djr299.
Christiansen P, et al. Mortality Rates Among Early-stage Hormone Receptor-positive Breast Cancer Patients: a Population-based Cohort Study in Denmark. J Natl Cancer Inst. 2011 Sep 21;103(18):1363-72. PubMed PMID: 21881042.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mortality rates among early-stage hormone receptor-positive breast cancer patients: a population-based cohort study in Denmark. AU - Christiansen,Peer, AU - Bjerre,Karsten, AU - Ejlertsen,Bent, AU - Jensen,Maj-Britt, AU - Rasmussen,Birgitte B, AU - Lænkholm,Anne-Vibeke, AU - Kroman,Niels, AU - Ewertz,Marianne, AU - Offersen,Birgitte, AU - Toftdahl,Dorte B, AU - Møller,Susanne, AU - Mouridsen,Henning T, AU - ,, Y1 - 2011/08/31/ PY - 2011/9/2/entrez PY - 2011/9/2/pubmed PY - 2011/11/9/medline SP - 1363 EP - 72 JF - Journal of the National Cancer Institute JO - J. Natl. Cancer Inst. VL - 103 IS - 18 N2 - BACKGROUND: Indications for adjuvant endocrine treatment of breast cancer have gradually increased over the past several years. We aimed to define subgroups of patients who may or may not benefit from adjuvant endocrine therapy. METHODS: A population-based cohort of systemically untreated breast cancer patients (N = 3197) were identified within the registry of the Danish Breast Cancer Cooperative Group (DBCG). The patients were node negative and had estrogen receptor-positive and/or progesterone receptor-positive tumors (except medullary tumors) and were further characterized by the following risk factors: aged 35-74 years (grouped into 5-year categories) at surgery, tumor size (≤20 mm), and histopathology (grade 1 ductal carcinoma, grade 1 or 2 invasive lobular carcinoma, other or unknown histopathology). Standardized mortality ratios (SMRs) were calculated based on the mortality rate (observed number of deaths per 100,000 person-years) among patients relative to the mortality rate in the general population of women (expected number of deaths per 100,000 person-years). The association between standardized mortality ratio and risk factors were analyzed in univariate and multivariable Poisson regression models. All findings were validated in a subsequent DBCG cohort of breast cancer patients (N = 2710). RESULTS: The median follow-up after surgery was 14.8 years. In the study population there were 970 deaths compared with expected death of 737 women, which was an excess mortality of 233 deaths (SMR = 1.32, 95% CI = 1.24 to 1.40). Mortality rates were 2356 per 100,000 person-years in the study population and 1790 per 100,000 person-years in the general population of women. The mortality rate was associated with larger tumor size (11-20 mm tumors vs 1-10 mm tumors, SMR = 1.42, 95% confidence interval [CI] = 1.31 to 1.53 vs. SMR = 1.12, 95% CI = 1.00 to 1.26). The mortality rate was also associated with age (35-59 years, SMR > 1) compared with that in the general population of age-matched women, except for a small subgroup of patients (aged 60-74 years, tumors ≤10 mm, grade 1 ductal carcinoma, and grade 1 or 2 lobular carcinoma: adjusted relative risk = 1.02, 95% CI = 0.89 to 1.16.). CONCLUSIONS: A small subgroup of breast cancer patients who were 60 years or older and had hormone-responsive early-stage tumors up to 10 mm, and received no systemic adjuvant therapy, were not at increased risk of mortality compared with women in this age-group in the general population. SN - 1460-2105 UR - https://www.unboundmedicine.com/medline/citation/21881042/Mortality_rates_among_early_stage_hormone_receptor_positive_breast_cancer_patients:_a_population_based_cohort_study_in_Denmark_ L2 - https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djr299 DB - PRIME DP - Unbound Medicine ER -