Ethnicity and outcome of young breast cancer patients in the United Kingdom: the POSH study.
BACKGROUND: Black ethnic groups have a higher breast cancer mortality than Whites. American studies have identified variations in tumour biology and unequal health-care access as causative factors. We compared tumour pathology, treatment and outcomes in three ethnic groups in young breast cancer pat...
| 主要な著者: | , , , , , , , , , , , |
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| フォーマット: | Journal article |
| 言語: | English |
| 出版事項: |
2014
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| _version_ | 1826306415073951744 |
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| author | Copson, E Maishman, T Gerty, S Eccles, B Stanton, L Cutress, R Altman, D Durcan, L Simmonds, P Jones, L Tapper, W Eccles, D |
| author_facet | Copson, E Maishman, T Gerty, S Eccles, B Stanton, L Cutress, R Altman, D Durcan, L Simmonds, P Jones, L Tapper, W Eccles, D |
| author_sort | Copson, E |
| collection | OXFORD |
| description | BACKGROUND: Black ethnic groups have a higher breast cancer mortality than Whites. American studies have identified variations in tumour biology and unequal health-care access as causative factors. We compared tumour pathology, treatment and outcomes in three ethnic groups in young breast cancer patients treated in the United Kingdom. METHODS: Women aged ≤ 40 years at breast cancer diagnosis were recruited to the POSH national cohort study (MREC: 00/06/69). Personal characteristics, tumour pathology and treatment data were collected at diagnosis. Follow-up data were collected annually. Overall survival (OS) and distant relapse-free survival (DRFS) were assessed using Kaplan-Meier curves, and multivariate analyses were performed using Cox regression. RESULTS: Ethnicity data were available for 2915 patients including 2690 (91.0%) Whites, 118 (4.0%) Blacks and 87 (2.9%) Asians. Median tumour diameter at presentation was greater in Blacks than Whites (26.0 mm vs 22.0 mm, P=0.0103), and multifocal tumours were more frequent in both Blacks (43.4%) and Asians (37.0%) than Whites (28.9%). ER/PR/HER2-negative tumours were significantly more frequent in Blacks (26.1%) than Whites (18.6%, P=0.043). Use of chemotherapy was similarly high in all ethnic groups (89% B vs 88.6% W vs 89.7% A). A 5-year DRFS was significantly lower in Blacks than Asians (62.8% B vs 77.0% A, P=0.0473) or Whites (62.8 B% vs 77.0% W, P=0.0053) and a 5-year OS for Black patients, 71.1% (95% CI: 61.0-79.1%), was significantly lower than that of Whites (82.4%, 95% CI: 80.8-83.9%, W vs B: P=0.0160). In multivariate analysis, Black ethnicity had an effect on DRFS in oestrogen receptor (ER)-positive patients that is independent of body mass index, tumour size, grade or nodal status, HR: 1.60 (95% CI: 1.03-2.47, P=0.035). CONCLUSION: Despite equal access to health care, young Black women in the United Kingdom have a significantly poorer outcome than White patients. Black ethnicity is an independent risk factor for reduced DRFS particularly in ER-positive patients. |
| first_indexed | 2024-03-07T06:47:37Z |
| format | Journal article |
| id | oxford-uuid:fb656415-5d1e-4419-9f90-7fc65a7ad9ae |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T06:47:37Z |
| publishDate | 2014 |
| record_format | dspace |
| spelling | oxford-uuid:fb656415-5d1e-4419-9f90-7fc65a7ad9ae2022-03-27T13:13:31ZEthnicity and outcome of young breast cancer patients in the United Kingdom: the POSH study.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:fb656415-5d1e-4419-9f90-7fc65a7ad9aeEnglishSymplectic Elements at Oxford2014Copson, EMaishman, TGerty, SEccles, BStanton, LCutress, RAltman, DDurcan, LSimmonds, PJones, LTapper, WEccles, DBACKGROUND: Black ethnic groups have a higher breast cancer mortality than Whites. American studies have identified variations in tumour biology and unequal health-care access as causative factors. We compared tumour pathology, treatment and outcomes in three ethnic groups in young breast cancer patients treated in the United Kingdom. METHODS: Women aged ≤ 40 years at breast cancer diagnosis were recruited to the POSH national cohort study (MREC: 00/06/69). Personal characteristics, tumour pathology and treatment data were collected at diagnosis. Follow-up data were collected annually. Overall survival (OS) and distant relapse-free survival (DRFS) were assessed using Kaplan-Meier curves, and multivariate analyses were performed using Cox regression. RESULTS: Ethnicity data were available for 2915 patients including 2690 (91.0%) Whites, 118 (4.0%) Blacks and 87 (2.9%) Asians. Median tumour diameter at presentation was greater in Blacks than Whites (26.0 mm vs 22.0 mm, P=0.0103), and multifocal tumours were more frequent in both Blacks (43.4%) and Asians (37.0%) than Whites (28.9%). ER/PR/HER2-negative tumours were significantly more frequent in Blacks (26.1%) than Whites (18.6%, P=0.043). Use of chemotherapy was similarly high in all ethnic groups (89% B vs 88.6% W vs 89.7% A). A 5-year DRFS was significantly lower in Blacks than Asians (62.8% B vs 77.0% A, P=0.0473) or Whites (62.8 B% vs 77.0% W, P=0.0053) and a 5-year OS for Black patients, 71.1% (95% CI: 61.0-79.1%), was significantly lower than that of Whites (82.4%, 95% CI: 80.8-83.9%, W vs B: P=0.0160). In multivariate analysis, Black ethnicity had an effect on DRFS in oestrogen receptor (ER)-positive patients that is independent of body mass index, tumour size, grade or nodal status, HR: 1.60 (95% CI: 1.03-2.47, P=0.035). CONCLUSION: Despite equal access to health care, young Black women in the United Kingdom have a significantly poorer outcome than White patients. Black ethnicity is an independent risk factor for reduced DRFS particularly in ER-positive patients. |
| spellingShingle | Copson, E Maishman, T Gerty, S Eccles, B Stanton, L Cutress, R Altman, D Durcan, L Simmonds, P Jones, L Tapper, W Eccles, D Ethnicity and outcome of young breast cancer patients in the United Kingdom: the POSH study. |
| title | Ethnicity and outcome of young breast cancer patients in the United Kingdom: the POSH study. |
| title_full | Ethnicity and outcome of young breast cancer patients in the United Kingdom: the POSH study. |
| title_fullStr | Ethnicity and outcome of young breast cancer patients in the United Kingdom: the POSH study. |
| title_full_unstemmed | Ethnicity and outcome of young breast cancer patients in the United Kingdom: the POSH study. |
| title_short | Ethnicity and outcome of young breast cancer patients in the United Kingdom: the POSH study. |
| title_sort | ethnicity and outcome of young breast cancer patients in the united kingdom the posh study |
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