Age-specific incidence of breast cancer subtypes: Understanding the black-white crossover

Christina A. Clarke, Theresa H Keegan, Juan Yang, David J. Press, Allison W. Kurian, Anish H. Patel, James V. Lacey

Research output: Contribution to journalArticle

123 Citations (Scopus)

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 populationbased data to examine whether the age-specific incidences of breast cancer subtypes vary by race and ethnicity. Methods We classified 91 908 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.

Original languageEnglish (US)
Pages (from-to)1094-1101
Number of pages8
JournalJournal of the National Cancer Institute
Volume104
Issue number14
DOIs
StatePublished - Jul 18 2012
Externally publishedYes

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Breast Neoplasms
Incidence
Hormones
Progesterone Receptors
Estrogen Receptors
Triple Negative Breast Neoplasms
hydroquinone
human ERBB2 protein
Hispanic Americans
Confidence Intervals
Neoplasms

ASJC Scopus subject areas

  • Medicine(all)
  • Oncology
  • Cancer Research

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Age-specific incidence of breast cancer subtypes : Understanding the black-white crossover. / Clarke, Christina A.; Keegan, Theresa H; Yang, Juan; Press, David J.; Kurian, Allison W.; Patel, Anish H.; Lacey, James V.

In: Journal of the National Cancer Institute, Vol. 104, No. 14, 18.07.2012, p. 1094-1101.

Research output: Contribution to journalArticle

Clarke, Christina A. ; Keegan, Theresa H ; Yang, Juan ; Press, David J. ; Kurian, Allison W. ; Patel, Anish H. ; Lacey, James V. / Age-specific incidence of breast cancer subtypes : Understanding the black-white crossover. In: Journal of the National Cancer Institute. 2012 ; Vol. 104, No. 14. pp. 1094-1101.
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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 populationbased data to examine whether the age-specific incidences of breast cancer subtypes vary by race and ethnicity. Methods We classified 91 908 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.",
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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 populationbased data to examine whether the age-specific incidences of breast cancer subtypes vary by race and ethnicity. Methods We classified 91 908 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.

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