Short-term breast cancer survival in relation to ethnicity, stage, grade and receptor status: National cohort study in England

M�ller, Henrik; Henson, Katherine; L�chtenborg, Margreet; Broggio, John; Charman, Jackie; Coupland, Victoria H.; Davies, Elizabeth; Jack, Ruth H.; Sullivan, Richard; Vedsted, Peter; Horgan, Kieran; Pearce, Neil; Purushotham, Arnie

Abstract

Background:In the re-organisation of cancer registration in England in 2012, a high priority was given to the recording of cancer stage and other prognostic clinical data items.Methods:We extracted 86 852 breast cancer records for women resident in England and diagnosed during 2012-2013. Information on age, ethnicity, socio-economic status, comorbidity, tumour stage, grade, morphology and oestrogen, progesterone and HER2 receptor status was included. The two-year cumulative risk of death from any cause was estimated with the Kaplan-Meier method, and univariate and multivariate Cox proportional hazards regressions were used to estimate hazard ratios (HR) and their 95% confidence intervals (95% CI). The follow-up ended on 31 December 2014.Results:The completeness of registration for prognostic variables was generally high (around 80% or higher), but it was low for progesterone receptor status (41%). Women with negative receptor status for each of the oestrogen, progesterone and HER2 receptors (triple-negative cancers) had an adjusted HR for death of 2.00 (95%CI 1.84-2.17). Black women had an age-adjusted HR of 1.77 (1.48-2.13) compared with White women.Conclusions:The excess mortality of Black women with breast cancer has contributions from socio-economic factors, stage distribution and tumour biology. The study illustrates the richness of detail in the national cancer registration data. This allows for analysis of cancer outcomes at a high level of resolution, and may form the basis for risk stratification.

• Journal Article Type: Article
• Acceptance Date: Sep 25, 2016
• Online Publication Date: Oct 25, 2016
• Publication Date: Nov 22, 2016
• Deposit Date: Sep 24, 2020
• Publicly Available Date: Feb 1, 2021
• Journal: British Journal of Cancer
• Print ISSN: 0007-0920
• Electronic ISSN: 1532-1827
• Publisher: Cancer Research UK
• Peer Reviewed: Peer Reviewed
• Volume: 115
• Issue: 11
• Pages: 1408-1415
• DOI: https://doi.org/10.1038/bjc.2016.335
• Keywords: breast cancer survival; ethnicity; stage; grade; receptors
• Public URL: https://nottingham-repository.worktribe.com/output/3223641
• Publisher URL: https://www.nature.com/articles/bjc2016335