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Age-specific incidence of breast cancer subtypes: understanding the black-white crossover.
J Natl Cancer Inst. 2012 Jul 18; 104(14):1094-101.JNCI

Abstract

BACKGROUND

Breast cancer incidence is higher among black women than white women before age 40 years, but higher among white women than black women after age 40 years (black-white crossover). We used newly available population-based data to examine whether the age-specific incidences of breast cancer subtypes vary by race and ethnicity.

METHODS

We classified 91908 invasive breast cancers diagnosed in California between January 1, 2006, and December 31, 2009, by subtype based on tumor expression of estrogen receptor (ER) and progesterone receptor (PR)-together referred to as hormone receptor (HR)-and human epidermal growth factor receptor 2 (HER2). Breast cancer subtypes were classified as ER or PR positive and HER2 negative (HR(+)/HER2(-)), ER or PR positive and HER2 positive (HR(+)/HER2(+)), ER and PR negative and HER2 positive (HR(-)/HER2(+)), and ER, PR, and HER2 negative (triple-negative). We calculated and compared age-specific incidence rates, incidence rate ratios, and 95% confidence intervals by subtype and race (black, white, Hispanic, and Asian). All P values are two-sided.

RESULTS

We did not observe an age-related black-white crossover in incidence for any molecular subtype of breast cancer. Compared with white women, black women had statistically significantly higher rates of triple-negative breast cancer at all ages but statistically significantly lower rates of HR(+)/HER2(-) breast cancers after age 35 years (all P < .05). The age-specific incidence of HR(+)/HER2(+) and HR(-)/HER2(+) subtypes did not vary markedly between white and black women.

CONCLUSIONS

The black-white crossover in breast cancer incidence occurs only when all breast cancer subtypes are combined and relates largely to higher rates of triple-negative breast cancers and lower rates of HR(+)/HER2(-) breast cancers in black vs white women.

Authors+Show Affiliations

Research Scientist, Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA 94538-2334, USA. tina@cpic.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

22773826

Citation

Clarke, Christina A., et al. "Age-specific Incidence of Breast Cancer Subtypes: Understanding the Black-white Crossover." Journal of the National Cancer Institute, vol. 104, no. 14, 2012, pp. 1094-101.
Clarke CA, Keegan TH, Yang J, et al. Age-specific incidence of breast cancer subtypes: understanding the black-white crossover. J Natl Cancer Inst. 2012;104(14):1094-101.
Clarke, C. A., Keegan, T. H., Yang, J., Press, D. J., Kurian, A. W., Patel, A. H., & Lacey, J. V. (2012). Age-specific incidence of breast cancer subtypes: understanding the black-white crossover. Journal of the National Cancer Institute, 104(14), 1094-101. https://doi.org/10.1093/jnci/djs264
Clarke CA, et al. Age-specific Incidence of Breast Cancer Subtypes: Understanding the Black-white Crossover. J Natl Cancer Inst. 2012 Jul 18;104(14):1094-101. PubMed PMID: 22773826.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Age-specific incidence of breast cancer subtypes: understanding the black-white crossover. AU - Clarke,Christina A, AU - Keegan,Theresa H M, AU - Yang,Juan, AU - Press,David J, AU - Kurian,Allison W, AU - Patel,Anish H, AU - Lacey,James V,Jr Y1 - 2012/07/05/ PY - 2012/7/10/entrez PY - 2012/7/10/pubmed PY - 2012/9/26/medline SP - 1094 EP - 101 JF - Journal of the National Cancer Institute JO - J. Natl. Cancer Inst. VL - 104 IS - 14 N2 - BACKGROUND: Breast cancer incidence is higher among black women than white women before age 40 years, but higher among white women than black women after age 40 years (black-white crossover). We used newly available population-based data to examine whether the age-specific incidences of breast cancer subtypes vary by race and ethnicity. METHODS: We classified 91908 invasive breast cancers diagnosed in California between January 1, 2006, and December 31, 2009, by subtype based on tumor expression of estrogen receptor (ER) and progesterone receptor (PR)-together referred to as hormone receptor (HR)-and human epidermal growth factor receptor 2 (HER2). Breast cancer subtypes were classified as ER or PR positive and HER2 negative (HR(+)/HER2(-)), ER or PR positive and HER2 positive (HR(+)/HER2(+)), ER and PR negative and HER2 positive (HR(-)/HER2(+)), and ER, PR, and HER2 negative (triple-negative). We calculated and compared age-specific incidence rates, incidence rate ratios, and 95% confidence intervals by subtype and race (black, white, Hispanic, and Asian). All P values are two-sided. RESULTS: We did not observe an age-related black-white crossover in incidence for any molecular subtype of breast cancer. Compared with white women, black women had statistically significantly higher rates of triple-negative breast cancer at all ages but statistically significantly lower rates of HR(+)/HER2(-) breast cancers after age 35 years (all P < .05). The age-specific incidence of HR(+)/HER2(+) and HR(-)/HER2(+) subtypes did not vary markedly between white and black women. CONCLUSIONS: The black-white crossover in breast cancer incidence occurs only when all breast cancer subtypes are combined and relates largely to higher rates of triple-negative breast cancers and lower rates of HR(+)/HER2(-) breast cancers in black vs white women. SN - 1460-2105 UR - https://www.unboundmedicine.com/medline/citation/22773826/Age_specific_incidence_of_breast_cancer_subtypes:_understanding_the_black_white_crossover_ L2 - https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djs264 DB - PRIME DP - Unbound Medicine ER -