Trends in breast cancer specific death by clinical stage at diagnoses between 2000-2017.

IF 9.9 1区医学 Q1 ONCOLOGY

JNCI Journal of the National Cancer Institute Pub Date : 2024-09-30 DOI:10.1093/jnci/djae241

Michal Marczyk, Adriana Kahn, Andrea Silber, Mariya Rosenblit, Michael P Digiovanna, Maryam Lustberg, Lajos Pusztai

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Abstract

Background: Approximately 40,000 individuals die from metastatic breast cancer each year. We examined what fractions of annual breast cancer-specific death (BCSD) are due to stage I, II, III, IV disease and if these proportions changed over time.

Methods: We used data from SEER covering 1975 to 2017. After filtering for female sex at birth, one primary tumor type, surgery, AJCC (6th edition) stage > 0, no bilateral cancer, and survival data available, the final analysis included 972,763 patients. Temporal trends were assessed using a linear model and ANOVA test.

Results: The contribution of stage I and II cancers to BCSD increased significantly from 16.2% to 23.1%, and from 30.7% to 39.5%, respectively between 2000 and 2017. The contribution of stages III and IV cancers decreased from 36.4% to 30.3%, and from 16.7% to 7.1%. In 2000, 0.92%, 4.0% and 10.7% of BCSD were due to T1a, T1b, and T1c node-negative cancers which increased significantly to 1.9%, 5.8%, and 14.7% by 2017. These temporal trends were similar for hormone receptor-positive and -negative cancers. The contribution of BCSD to all-cause mortality declined from 23.9% to 16.6% for stage I, and from 47.7% to 36.9% for stage II cancers by 2017.

Conclusions: Patients with stage I/II breast cancers have excellent prognosis, yet these cancers account for over 60% of current BCSD because of their large absolute numbers. To further reduce breast cancer death strategies are needed to identify and treat patients with stage I/II disease who remain at risk for recurrence.

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2000-2017 年间按诊断时的临床阶段划分的乳腺癌特定死亡趋势。

背景：每年约有 40,000 人死于转移性乳腺癌：每年约有 40,000 人死于转移性乳腺癌。我们研究了每年乳腺癌特异性死亡（BCSD）中因 I、II、III、IV 期疾病死亡的比例，以及这些比例是否随着时间的推移而发生变化：我们使用了 SEER 1975 年至 2017 年的数据。在对出生时的女性性别、一种原发肿瘤类型、手术、AJCC（第 6 版）分期 > 0、无双侧性癌症和可用生存数据进行筛选后，最终分析包括 972,763 名患者。采用线性模型和方差分析检验对时间趋势进行了评估：2000年至2017年间，I期和II期癌症对BCSD的贡献率分别从16.2%和30.7%大幅增至23.1%和39.5%。III期和IV期癌症所占比例从36.4%降至30.3%，从16.7%降至7.1%。2000 年，T1a、T1b 和 T1c 结节阴性癌症分别占 BCSD 的 0.92%、4.0% 和 10.7%，到 2017 年，这一比例大幅上升至 1.9%、5.8% 和 14.7%。这些时间趋势与激素受体阳性和阴性癌症相似。到2017年，BCSD对全因死亡率的贡献率在I期癌症中从23.9%降至16.6%，在II期癌症中从47.7%降至36.9%：结论：I/II期乳腺癌患者预后良好，但由于其绝对数量大，占目前BSD的60%以上。为进一步降低乳腺癌死亡率，需要制定策略，识别并治疗仍有复发风险的 I/II 期患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JNCI Journal of the National Cancer Institute 医学-肿瘤学

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.