PURPOSE: Since 1990, overall breast cancer mortality rates in the United States decreased 24%. This decline has been attributed to mammography screening and adjuvant systemic therapy. However, the efficacy of these modalities may depend on estrogen receptor (ER) expression and age. We therefore examined breast cancer mortality trends in the United States according to ER status and age. METHODS: Using the Surveillance, Epidemiology, and End Results (SEER) program (1990-2003), we calculated trends in incidence-based mortality (IBM), annual hazard rates for breast cancer deaths after diagnosis, and relative hazard rates for women with ER-positive and ER-negative tumors. Relative hazard rates were assessed with Cox proportional hazards models, adjusted for stage and grade, and stratified by age at diagnosis. RESULTS: During the study period, IBM and annual hazard rates for breast cancer deaths decreased among women with ER-positive and ER-negative tumors, although declines were greater for those with ER-positive tumors. Among women younger than 70 years, relative hazard rates declined 38% for those with ER-positive tumors versus 19% for those with ER-negative tumors. Among women 70 years or older, relative hazard rates declined 14% for those with ER-positive tumors versus no significant decline for those with ER-negative tumors. CONCLUSION: In the United States, breast cancer mortality rates have declined among women with ER-positive and ER-negative tumors, with greater declines among younger women and those with ER-positive tumors. Although mortality in all groups remains unacceptably high, additional emphasis should be placed on improving outcomes of breast cancer patients older than 70 years and those of all ages with ER-negative tumors.
PURPOSE: Since 1990, overall breast cancer mortality rates in the United States decreased 24%. This decline has been attributed to mammography screening and adjuvant systemic therapy. However, the efficacy of these modalities may depend on estrogen receptor (ER) expression and age. We therefore examined breast cancer mortality trends in the United States according to ER status and age. METHODS: Using the Surveillance, Epidemiology, and End Results (SEER) program (1990-2003), we calculated trends in incidence-based mortality (IBM), annual hazard rates for breast cancer deaths after diagnosis, and relative hazard rates for women with ER-positive and ER-negative tumors. Relative hazard rates were assessed with Cox proportional hazards models, adjusted for stage and grade, and stratified by age at diagnosis. RESULTS: During the study period, IBM and annual hazard rates for breast cancer deaths decreased among women with ER-positive and ER-negative tumors, although declines were greater for those with ER-positive tumors. Among women younger than 70 years, relative hazard rates declined 38% for those with ER-positive tumors versus 19% for those with ER-negative tumors. Among women 70 years or older, relative hazard rates declined 14% for those with ER-positive tumors versus no significant decline for those with ER-negative tumors. CONCLUSION: In the United States, breast cancer mortality rates have declined among women with ER-positive and ER-negative tumors, with greater declines among younger women and those with ER-positive tumors. Although mortality in all groups remains unacceptably high, additional emphasis should be placed on improving outcomes of breast cancerpatients older than 70 years and those of all ages with ER-negative tumors.
Authors: Nadia Howlader; Lindsay M Morton; Eric J Feuer; Caroline Besson; Eric A Engels Journal: Cancer Epidemiol Biomarkers Prev Date: 2015-10-15 Impact factor: 4.254
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Authors: Sylvia K Plevritis; Diego Munoz; Allison W Kurian; Natasha K Stout; Oguzhan Alagoz; Aimee M Near; Sandra J Lee; Jeroen J van den Broek; Xuelin Huang; Clyde B Schechter; Brian L Sprague; Juhee Song; Harry J de Koning; Amy Trentham-Dietz; Nicolien T van Ravesteyn; Ronald Gangnon; Young Chandler; Yisheng Li; Cong Xu; Mehmet Ali Ergun; Hui Huang; Donald A Berry; Jeanne S Mandelblatt Journal: JAMA Date: 2018-01-09 Impact factor: 56.272
Authors: Claudine Isaacs; Pia Herbolsheimer; Minetta C Liu; Mary Wilkinson; Yvonne Ottaviano; Gina G Chung; Robert Warren; Jennifer Eng-Wong; Philip Cohen; Karen L Smith; Karen Creswell; Antonella Novielli; Rebecca Slack Journal: Breast Cancer Res Treat Date: 2010-10-26 Impact factor: 4.872
Authors: Robert A Kruger; Cherie M Kuzmiak; Richard B Lam; Daniel R Reinecke; Stephen P Del Rio; Doreen Steed Journal: Med Phys Date: 2013-11 Impact factor: 4.071
Authors: Ronald E Gangnon; Natasha K Stout; Oguzhan Alagoz; John M Hampton; Brian L Sprague; Amy Trentham-Dietz Journal: Med Decis Making Date: 2018-04 Impact factor: 2.583