底特律癌症幸存者研究队列中黑色激素受体阳性乳腺癌幸存者的处方和自我报告使用内分泌治疗

IF 3 3区医学 Q2 ONCOLOGY

Breast Cancer Research and Treatment Pub Date : 2025-09-09 DOI:10.1007/s10549-025-07816-1

Abigail M Fielder, Seongho Kim, Julie J Ruterbusch, Cydnie Martin, Anna Gottschlich, Ann G Schwartz, Jennifer L Beebe-Dimmer, Hadeel Assad, Lauren Hamel, Kristen S Purrington

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引用次数: 0

摘要

目的：患有激素受体阳性（HR +）乳腺癌的黑人妇女患弱HR +肿瘤（1-10%阳性细胞）的可能性是白人妇女的两倍。弱HR +肿瘤患者较少接受ET治疗，其死亡率比强HR +肿瘤（bbb10 %阳性细胞）高60%。我们评估了黑人女性HR +乳腺癌患者中与ET处方和自我报告使用相关的因素。方法：在922名底特律ROCS参与者中，我们评估了人口统计学、社会经济地位、健康、肿瘤、肿瘤学家和医院特征与ET处方意图和自我报告的ET使用之间的关系。采用Logistic混合效应回归分析肿瘤医师和医院组效应。结果：肿瘤学家打算给83.4%的参与者（n = 769）开ET，其中54.4% （n = 502）报告使用了ET。在多变量模型中，弱HR +肿瘤患者服用ET的可能性降低90% (OR = 0.10, p 2 (OR = 0.45, p = 0.0085)， HR阳性> 90% vs. 11-90% (OR = 0.37, p = 0.00045)， HR百分比未知（OR = 0.12, p）结论：确定与ET使用相关的多水平因素可能为改善黑人HR +乳腺癌女性ET摄取和生存率提供策略。

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Prescription and self-reported use of endocrine therapy among black hormone receptor-positive breast cancer survivors in the Detroit Research on Cancer Survivors cohort.

Purpose: Black women with hormone receptor-positive (HR +) breast cancer are twice as likely as White women to have weakly HR + tumors (1-10% positive cells). Patients with weakly HR + tumors are less frequently prescribed ET and have 60% higher mortality than strongly HR + tumors (> 10% positive cells). We evaluated factors associated with ET prescription and self-reported use among Black women with HR + breast cancer.

Methods: Among 922 Detroit ROCS participants, we evaluated associations between demographics, socioeconomic status, and health, tumor, oncologist, and hospital characteristics and ET prescription intent and self-reported ET use. Logistic mixed-effects regression was used to account for oncologist and hospital group effects.

Results: Oncologists intended to prescribe ET to 83.4% of participants (n = 769), of which 54.4% (n = 502) reported use. In multivariable models, participants with weakly HR + tumors were 90% less likely to be prescribed ET (OR = 0.10, p < 0.0001). Other significant characteristics of ET prescription included a BMI of 25-29.9 kg/m² (OR = 0.45, p = 0.0085), HR positivity > 90% vs. 11-90% (OR = 0.37, p = 0.00045), unknown HR percentage (OR = 0.12, p < 0.0001), OncotypeDx testing (OR = 2.65, p < 0.0001), and receiving radiation (OR = 2.20, p = 0.00016). Self-reported ET use was lower among those with lower health literacy (OR = 0.017, p < 0.001), weak HR positivity (OR = 0.46, p = 0.0053), unknown HR percentage (OR = 0.074, p = 0.034), and older age at diagnosis (OR = 0.88, p = 0.002). Increased ET use was associated with an income between $60,000-$79,900 vs. < $20,000 (OR = 1.54, p = 0.035), higher comorbidity count (OR = 1.09, p = 0.0054), distant stage (OR = 2.03, p = 0.029), and surgery (OR = 2.35, p = 0.001).

Conclusion: Identifying multilevel factors related to ET use may inform strategies to improve ET uptake and survival among Black women with HR + breast cancer.

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来源期刊

Breast Cancer Research and Treatment 医学-肿瘤学

CiteScore

6.80

自引率

2.60%

发文量

342

审稿时长

1 months

期刊介绍： Breast Cancer Research and Treatment provides the surgeon, radiotherapist, medical oncologist, endocrinologist, epidemiologist, immunologist or cell biologist investigating problems in breast cancer a single forum for communication. The journal creates a "market place" for breast cancer topics which cuts across all the usual lines of disciplines, providing a site for presenting pertinent investigations, and for discussing critical questions relevant to the entire field. It seeks to develop a new focus and new perspectives for all those concerned with breast cancer.