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. 2012 Jul 18;104(14):1094-101.
doi: 10.1093/jnci/djs264. Epub 2012 Jul 5.

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

Christina A Clarke  1 , Theresa H M Keegan, Juan Yang, David J Press, Allison W Kurian, Anish H Patel, James V Lacey Jr
Affiliations

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

Christina A Clarke et al. J Natl Cancer Inst. .

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 population-based data to examine whether the age-specific incidences of breast cancer subtypes vary by race and ethnicity.

Methods: We classified 91908 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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Figures

Figure 1.
Figure 1.
Distribution of breast cancer subtypes, by race and ethnicity, among California women, 2006–2009. HR+ = hormone receptor-positive; HER2– = HER2-negative; HR– = hormone receptor–negative; HER2+ = HER2-positive; TNBC = triple-negative breast cancer.
Table 1.
Table 1.
Distribution of female breast cancer patients by age, race/ethnicity, and subtype, California, 2006–2009*
Figure 2.
Figure 2.
Age-specific incidence rates of breast cancer by A) race and ethnicity and by B) molecular subtype, among California women, 2006–2009. HR+ = hormone receptor-positive; HER2- = HER2-negative; HR- = hormone receptor-negative; HER2+ = HER2-positive; TNBC = triple-negative breast cancer.
Figure 3.
Figure 3.
Distribution of breast cancer subtypes, by race and ethnicity, among California women, 2006–2009. HR+ = hormone receptor-positive; HER2– = HER2-negative; HR– = hormone receptor–negative; HER2+ = HER2-positive; TNBC = triple-negative breast cancer.
See this image and copyright information in PMC

Comment in

References

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