PO.SHP01.01 · 科学与健康政策
种族/族裔对继发性三阴性乳腺癌生存的影响
The impact of race/ethnicity on survival in secondary triple negative breast cancer
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
目的：确定用于继发性三阴性乳腺癌的治疗是否与按种族/族裔划分的生存差异相关。
背景：继发性乳腺癌女性以及三阴性乳腺癌（TNBC）女性的生存较差，尤其是年轻女性，特别是非西班牙裔（nH）黑人女性。我们假设这与所接受的治疗有关。
方法：使用加州癌症登记处（California Cancer Registry）确定了 2003-2019 年间诊断为 TNBC 的 15-50 岁女性。多变量 logistic 回归比较了继发性与原发性 TNBC 的特征。多变量 Cox 比例风险回归模型评估了继发性与原发性 TNBC 对总生存（OS）和乳腺癌特异性生存（BCSS）的关联。分析按种族/族裔进行分层。
结果：在 682 名继发性 TNBC 女性中，48.5% 为 nH 白人，11.3% 为 nH 黑人，31% 为西班牙裔。所有继发性 TNBC（相较于原发性 TNBC）女性更有可能接受乳房切除术和非蒽环类化疗。nH 白人女性比其他种族/族裔女性更不可能接受腋窝淋巴结清扫术。患继发性（相较于原发性）TNBC 的西班牙裔和 nH 白人女性的 OS 和 BCSS 较差，而在 nH 黑人及亚裔/太平洋岛民女性中未观察到这一现象（图 1）。
结论：尽管按种族/族裔划分的继发性与原发性 TNBC 的治疗相似，但患继发性 TNBC 的西班牙裔和 nH 白人女性的生存较差。我们的研究结果提示，继发性 TNBC 中不同的是肿瘤生物学特征而非治疗，这需要不同的治疗策略以改善结局。
图 1：按种族/族裔划分的继发性相较于原发性三阴性乳腺癌的多变量校正 Cox 比例风险比（总生存和乳腺癌特异性生存）总生存 乳腺癌特异性生存
查看英文原文 English abstract
Objective: To identify if treatments used for secondary triple negative breast cancer are associated with survival differences by race/ethnicity.
Background: Survival in women with secondary breast cancer, and those with triple negative breast cancer (TNBC), is worse for young women, especially non-Hispanic (nH) Black women. We hypothesize this is related to treatment received.
Methods: Females, aged 15-50 years, diagnosed with a TNBC during 2003-2019 were identified using the California Cancer Registry. Multivariable logistic regression compared characteristics of secondary vs primary TNBC. Multivariable Cox proportional hazards regression models evaluated associations of secondary vs primary TNBC on overall survival (OS) and breast cancer specific survival (BCSS). Analyses were stratified by race/ethnicity.
Results: Of 682 women with a secondary TNBC, 48.5% were nH White, 11.3% were nH Black, and 31% were Hispanic. All women with a secondary TNBC (vs primary TNBC) were more likely to receive a mastectomy and non-anthracycline based chemotherapy. NH White women were less likely than women of other races/ethnicities to have axillary lymph node dissections. Hispanic and nH White women with a secondary (vs primary) TNBC experienced worse OS and BCSS, which was not seen in nH Black and Asian/Pacific Islander women (Figure 1).
Conclusion: While treatments were similar for secondary vs primary TNBCs by race/ethnicity, Hispanic and nH White women with secondary TNBC experienced worse survival. Our findings suggest that tumor biology, rather than treatment, differs in secondary TNBC, warranting different treatment algorithms to improve outcomes.
Figure 1: Multivariable Adjusted Cox Proportional Hazard Ratios for Overall Survival and Breast Cancer Specific Survival for Secondary compared to Primary Triple Negative Breast Cancer by Race/Ethnicity Overall Survival Breast Cancer Specific Survival
利益披露 Disclosure
A. Jacinto, None..
T. Keegan, None..
Q. Li, None..
F. Maguire, None..
C. Sauder, None.