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Treatment and survival of Asian women diagnosed with breast cancer in New Zealand

  • Epidemiology
  • Published:
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Abstract

Purpose

This study aims to examine the differences in characteristics, treatment and survival between Asian and European women diagnosed with stage I–III breast cancer in New Zealand.

Methods

The studied population included European women and Asian women diagnosed with stage I–III breast cancer between June 2000 and May 2013 identified from the combined Waikato and Auckland Breast Cancer Registers. Characteristics and treatment were compared between Asian and European women. Kaplan–Meier method was used to examine the survival difference. Cox proportional hazards model was used to estimate the hazard ratio (HR) of mortality.

Results

The studied cohort included 8608 European and 949 Asian women. Asian women were younger, had less comorbidities and were less likely to be obese than European women. Asian women were more likely to have grade 3, larger and HER2+  breast cancers. Asian women were more likely to receive mastectomy, less likely to have reconstruction after mastectomy, less likely to have chemotherapy, less likely to be treated with trastuzumab if HER2+, and had better adherence to endocrine therapy (adjusted odds ratio: 1.54; 95% CI 1.22–1.93). Asian women had better cancer-specific survival and all-cause survival than European women. The adjusted HR of cancer-specific mortality and all-cause mortality were 0.64 (95% CI 0.49–0.82) and 0.68 (95% CI 0.55–0.84), respectively.

Conclusions

Asian women are more likely to have high grade, larger and HER2+ breast cancers than European women. In spite of this, they had better breast cancer outcomes. Possible explanations include the differences in adherence to endocrine therapy, age, BMI and comorbidities.

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Acknowledgements

We would like to acknowledge the financial support from the Health Research Council of New Zealand, and also thank the Auckland and Waikato Breast Cancer Registers for providing the detailed data, and the New Zealand Breast Cancer Foundation and the Waikato Bay of Plenty Division of the Cancer Society for funding the Registers.

Funding

This study was funded by the New Zealand Health Research Council (Grant Number 14/484).

Author information

Authors and Affiliations

  1. Waikato Medical Research Centre, The University of Waikato, Private Bag 3105, Hamilton, 3240, New Zealand

    Chunhuan Lao & Ross Lawrenson

  2. School of Medicine, The University of Auckland, Auckland, New Zealand

    Melissa Edwards & Ian Campbell

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  1. Chunhuan Lao
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Correspondence to Chunhuan Lao.

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The authors declare that they have no conflicts of interest to disclose.

Research involving human participants and/or animals

This article does not contain any studies with human participants or animals performed by any of the authors. The study is covered under ethics approval from the Health and Disability Ethics Committee (HDEC) – Approval Number: 12/NTA/42/AM01.

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Lao, C., Lawrenson, R., Edwards, M. et al. Treatment and survival of Asian women diagnosed with breast cancer in New Zealand. Breast Cancer Res Treat 177, 497–505 (2019). https://doi.org/10.1007/s10549-019-05310-z

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