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Population-based recurrence rates among older women with HR-positive, HER2-negative early breast cancer: Clinical risk factors, frailty status, and differences by race

BACKGROUND: Multiple independent risk factors are associated with the prognosis of hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) breast cancer (BC), the most common BC subtype. This study describes U.S. population-based recurrence rates among older, resec...

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Autores principales: Zhou, Jifang, Cueto, Jenilee, Ko, Naomi Y., Hoskins, Kent F., Nabulsi, Nadia A., Asfaw, Alemseged A., Hubbard, Colin C., Mitra, Debanjali, Calip, Gregory S., Law, Ernest H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8379689/
https://www.ncbi.nlm.nih.gov/pubmed/34419726
http://dx.doi.org/10.1016/j.breast.2021.08.005
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author Zhou, Jifang
Cueto, Jenilee
Ko, Naomi Y.
Hoskins, Kent F.
Nabulsi, Nadia A.
Asfaw, Alemseged A.
Hubbard, Colin C.
Mitra, Debanjali
Calip, Gregory S.
Law, Ernest H.
author_facet Zhou, Jifang
Cueto, Jenilee
Ko, Naomi Y.
Hoskins, Kent F.
Nabulsi, Nadia A.
Asfaw, Alemseged A.
Hubbard, Colin C.
Mitra, Debanjali
Calip, Gregory S.
Law, Ernest H.
author_sort Zhou, Jifang
collection PubMed
description BACKGROUND: Multiple independent risk factors are associated with the prognosis of hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) breast cancer (BC), the most common BC subtype. This study describes U.S. population-based recurrence rates among older, resected women with HR+/HER2- early BC. METHODS: We conducted a retrospective cohort study of older women diagnosed with incident, invasive stages I-III HR+/HER2- BC who underwent surgery to remove the primary tumor using the Surveillance, Epidemiology, and End Results (SEER)-Medicare Linked Database (2007–2015). SEER records and administrative health claims data were used to ascertain patient and tumor-specific characteristics, treatment, and frailty status. Cumulative incidences of BC recurrence were estimated using a validated algorithm for administrative claims data. Multivariable Fine-Gray competing risk models estimated adjusted subdistribution hazards ratios and 95 % confidence intervals for associations with BC recurrence risk. RESULTS: Overall, 46,027 women age ≥65 years were included in our analysis. Over a median follow up of 7 years, 6531 women experienced BC recurrence with an estimated 3 and 5-year cumulative incidence rates of 10 % and 16 %, respectively. Higher 3- and 5-year cumulative incidences were observed in women with larger tumor size (5+ cm, 21 % and 28 %), lymph node involvement (4+ nodes, 27 % and 37 %), and with frail health status at diagnosis (13 % and 20 %). Independent of these clinical risk factors, Black, Hispanic and American Indian/Alaskan Native women had significantly increased BC recurrence risks. CONCLUSIONS: Rates of recurrence in HR+/HER2- early BC differs by several patient and clinical factors, including high-risk tumor characteristics. Racial differences in BC outcomes deserve continued attention from clinicians and policymakers.
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spelling pubmed-83796892021-08-27 Population-based recurrence rates among older women with HR-positive, HER2-negative early breast cancer: Clinical risk factors, frailty status, and differences by race Zhou, Jifang Cueto, Jenilee Ko, Naomi Y. Hoskins, Kent F. Nabulsi, Nadia A. Asfaw, Alemseged A. Hubbard, Colin C. Mitra, Debanjali Calip, Gregory S. Law, Ernest H. Breast Original Article BACKGROUND: Multiple independent risk factors are associated with the prognosis of hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) breast cancer (BC), the most common BC subtype. This study describes U.S. population-based recurrence rates among older, resected women with HR+/HER2- early BC. METHODS: We conducted a retrospective cohort study of older women diagnosed with incident, invasive stages I-III HR+/HER2- BC who underwent surgery to remove the primary tumor using the Surveillance, Epidemiology, and End Results (SEER)-Medicare Linked Database (2007–2015). SEER records and administrative health claims data were used to ascertain patient and tumor-specific characteristics, treatment, and frailty status. Cumulative incidences of BC recurrence were estimated using a validated algorithm for administrative claims data. Multivariable Fine-Gray competing risk models estimated adjusted subdistribution hazards ratios and 95 % confidence intervals for associations with BC recurrence risk. RESULTS: Overall, 46,027 women age ≥65 years were included in our analysis. Over a median follow up of 7 years, 6531 women experienced BC recurrence with an estimated 3 and 5-year cumulative incidence rates of 10 % and 16 %, respectively. Higher 3- and 5-year cumulative incidences were observed in women with larger tumor size (5+ cm, 21 % and 28 %), lymph node involvement (4+ nodes, 27 % and 37 %), and with frail health status at diagnosis (13 % and 20 %). Independent of these clinical risk factors, Black, Hispanic and American Indian/Alaskan Native women had significantly increased BC recurrence risks. CONCLUSIONS: Rates of recurrence in HR+/HER2- early BC differs by several patient and clinical factors, including high-risk tumor characteristics. Racial differences in BC outcomes deserve continued attention from clinicians and policymakers. Elsevier 2021-08-13 /pmc/articles/PMC8379689/ /pubmed/34419726 http://dx.doi.org/10.1016/j.breast.2021.08.005 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Zhou, Jifang
Cueto, Jenilee
Ko, Naomi Y.
Hoskins, Kent F.
Nabulsi, Nadia A.
Asfaw, Alemseged A.
Hubbard, Colin C.
Mitra, Debanjali
Calip, Gregory S.
Law, Ernest H.
Population-based recurrence rates among older women with HR-positive, HER2-negative early breast cancer: Clinical risk factors, frailty status, and differences by race
title Population-based recurrence rates among older women with HR-positive, HER2-negative early breast cancer: Clinical risk factors, frailty status, and differences by race
title_full Population-based recurrence rates among older women with HR-positive, HER2-negative early breast cancer: Clinical risk factors, frailty status, and differences by race
title_fullStr Population-based recurrence rates among older women with HR-positive, HER2-negative early breast cancer: Clinical risk factors, frailty status, and differences by race
title_full_unstemmed Population-based recurrence rates among older women with HR-positive, HER2-negative early breast cancer: Clinical risk factors, frailty status, and differences by race
title_short Population-based recurrence rates among older women with HR-positive, HER2-negative early breast cancer: Clinical risk factors, frailty status, and differences by race
title_sort population-based recurrence rates among older women with hr-positive, her2-negative early breast cancer: clinical risk factors, frailty status, and differences by race
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8379689/
https://www.ncbi.nlm.nih.gov/pubmed/34419726
http://dx.doi.org/10.1016/j.breast.2021.08.005
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