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Trends in 5-year survival rates among breast cancer patients by hormone receptor status and stage

  • Epidemiology
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Improvement in breast cancer survival has been observed in recent decades in the U.S., but it is unclear if similar survival gains are consistent across breast cancer subtypes, especially with regards to more advanced stages of the disease. Data were from 13 population-based cancer registries participating in the surveillance, epidemiology, and end results (SEER) program, consisting of women between 20 and 79 years of age diagnosed with invasive breast cancer between 1992 and 2008. 2-year (1992–2008) and 5-year (1992–2006) breast cancer cause-specific survival rates were calculated and stratified by estrogen receptor (ER)/progesterone receptor (PR) status, stage, and race. Annual percent changes in survival rates were assessed. From 1992 through 1998–1999, 5- and 2-year cause-specific survival rates significantly improved across ER+/PR+, ER−/PR−, and ER+/PR− subtypes, with an annual increase ranging from 0.5 to 1.0 % in the 5-year rates. From 1998–1999 to 2006, different patterns were observed by ER/PR subtypes with survival rates slightly improving for ER+/PR+, continuing to improve at a rate of 0.5 % per year for ER−/PR−, and dropping 0.3 % annually for ER+/PR−. No significant survival gains were experienced by patients with ER−/PR+ cancer during the study period. In terms of advanced diseases, greatest annual increases in survival rates were seen for patients with stage III–IV ER+/PR+ and ER−/PR− tumors but less progress was observed for advanced ER+/PR− breast cancers. Steady improvements in survival rates for breast cancer have been achieved over the past several decades. However, 5-year survival rates for stage IV disease remained dismally below 20 % for most ER/PR subtypes.

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  1. Howlader N, Noone AM, Krapcho M, et al (2013) SEER cancer statistics review, 1975–2010. Accessed 14 August 2014

  2. Howlader N, Noone AM, Krapcho M, et al (2014) SEER cancer statistics review, 1975–2011. Accessed 14 August 2014

  3. Berry DA, Cronin KA, Plevritis SK et al (2005) Effect of screening and adjuvant therapy on mortality from breast cancer. N Engl J Med 353:1784–1792

    Article  PubMed  CAS  Google Scholar 

  4. Giordano SH, Buzdar AU, Smith TL et al (2004) Is breast cancer survival improving? Cancer 100:44–52

    Article  PubMed  Google Scholar 

  5. Holleczek B, Brenner H (2012) Trends of population-based breast cancer survival in Germany and the US: decreasing discrepancies, but persistent survival gap of elderly patients in Germany. BMC Cancer 12:317

    Article  PubMed  PubMed Central  Google Scholar 

  6. Jatoi I, Chen BE, Anderson WF, Rosenberg PS (2007) Breast cancer mortality trends in the United States according to estrogen receptor status and age at diagnosis. J Clin Oncol 25:1683–1690

    Article  PubMed  Google Scholar 

  7. Dunnwald LK, Rossing MA, Li CI (2007) Hormone receptor status, tumor characteristics, and prognosis: a prospective cohort of breast cancer patients. Breast Cancer Res 9:R6

    Article  PubMed  PubMed Central  Google Scholar 

  8. Ademuyiwa FO, Groman A, Hong C-C et al (2013) Time-trends in survival in young women with breast cancer in a SEER population-based study. Breast Cancer Res Treat 138:241–248

    Article  PubMed  Google Scholar 

  9. Bartlett JMS, Brookes CL, Robson T et al (2011) Estrogen receptor and progesterone receptor as predictive biomarkers of response to endocrine therapy: a prospectively powered pathology study in the Tamoxifen and Exemestane Adjuvant Multinational trial. J Clin Oncol 29:1531–1538

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  10. Dowsett M, Allred C, Knox J et al (2008) Relationship between quantitative estrogen and progesterone receptor expression and human epidermal growth factor receptor 2 (HER-2) status with recurrence in the Arimidex, Tamoxifen, Alone or in Combination trial. J Clin Oncol 26:1059–1065

    Article  PubMed  CAS  Google Scholar 

  11. Bleyer A, Welch HG (2012) Effect of three decades of screening mammography on breast-cancer incidence. N Engl J Med 367:1998–2005

    Article  PubMed  CAS  Google Scholar 

  12. Boccardo F, Rubagotti A, Guglielmini P et al (2006) Switching to anastrozole versus continued tamoxifen treatment of early breast cancer. Updated results of the Italian tamoxifen anastrozole (ITA) trial. Ann Oncol 17(Suppl 7):vii10–vii14

    PubMed  Google Scholar 

  13. Smith RE, Good BC (2003) Chemoprevention of breast cancer and the trials of the national surgical adjuvant breast and bowel project and others. Endocr Relat Cancer 10:347–357

    Article  PubMed  CAS  Google Scholar 

  14. National cancer institute adjusted AJCC 6th ed. T, N, M, and stage—SEER documentation. Accessed 23 Jun 2014

  15. Statistical research and applications branch NCI jointpoint regression program, Version 4.0.1

  16. Kim HJ, Fay MP, Feuer EJMD (2000) Permutation tests for joinpoint regression with applications to cancer rates. Stat Med 19:335–351

    Article  PubMed  CAS  Google Scholar 

  17. Bérubé S, Provencher L, Robert J et al (2007) Quantitative exploration of possible reasons for the recent improvement in breast cancer survival. Breast Cancer Res Treat 106:419–431

    Article  PubMed  Google Scholar 

  18. Dawood S, Broglio K, Gonzalez-Angulo AM et al (2008) Trends in survival over the past two decades among white and black patients with newly diagnosed stage IV breast cancer. J Clin Oncol 26:4891–4898

    Article  PubMed  PubMed Central  Google Scholar 

  19. Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) (2005) Effects of chemotherapy and hormonal therapy for early breast cancer recurrence and 15 year survival:an overview of the randomized trials. Lancet 365:1687–1717

    Article  Google Scholar 

  20. Colozza M, de Azambuja E, Personeni N et al (2007) Achievements in systemic therapies in the pregenomic era in metastatic breast cancer. Oncologist 12:253–270

    Article  PubMed  CAS  Google Scholar 

  21. Riley GF, Warren JL, Harlan LC, Blackwell SA (2011) Endocrine therapy use among elderly hormone receptor-positive breast cancer patients enrolled in Medicare Part D. Medicare Medicaid Res Rev 1:E1–E25

    Article  Google Scholar 

  22. Mitri Z, Constantine T, O’Regan R (2012) The HER2 Receptor in Breast Cancer: pathophysiology, clinical use, and new advances in therapy. Chemother Res Pract 2012:743193

    PubMed  PubMed Central  Google Scholar 

  23. Carey LA, Perou CM, Livasy CA et al (2006) Race, breast cancer subtypes, and survival in the Carolina breast cancer study. JAMA 295:2492–2502

    Article  PubMed  CAS  Google Scholar 

  24. Hammond MEH, Hayes DF, Wolff AC et al (2010) American society of clinical oncology/college of American pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer. J Oncol Pract 6:195–197

    Article  PubMed  PubMed Central  Google Scholar 

  25. Cano G, Milanezi F, Leitão D et al (2003) Estimation of hormone receptor status in fine-needle aspirates and paraffin-embedded sections from breast cancer using the novel rabbit monoclonal antibodies SP1 and SP2. Diagn Cytopathol 29:207–211

    Article  PubMed  Google Scholar 

  26. Cheang MCU, Treaba DO, Speers CH et al (2006) Immunohistochemical detection using the new rabbit monoclonal antibody SP1 of estrogen receptor in breast cancer is superior to mouse monoclonal antibody 1D5 in predicting survival. J Clin Oncol 24:5637–5644

    Article  PubMed  CAS  Google Scholar 

  27. Welsh AW, Harigopal M, Wimberly H et al (2013) Quantitative analysis of estrogen receptor expression shows SP1 antibody is more sensitive than 1D5. Appl Immunohistochem Mol Morphol 21:139–147

    PubMed  PubMed Central  Google Scholar 

  28. Arpino G, Weiss H, Lee AV et al (2005) Estrogen receptor-positive, progesterone receptor-negative breast cancer: association with growth factor receptor expression and tamoxifen resistance. J Natl Cancer Inst 97:1254–1261

    Article  PubMed  CAS  Google Scholar 

  29. Yu K-D, Liu G-Y, Di G-H et al (2007) Progesterone receptor status provides predictive value for adjuvant endocrine therapy in older estrogen receptor-positive breast cancer patients. Breast 16:307–315

    Article  PubMed  Google Scholar 

  30. Carlson RW, Hudis CA, Pritchard KI (2006) Adjuvant endocrine therapy in hormone receptor-positive postmenopausal breast cancer: evolution of NCCN, ASCO, and St Gallen recommendations. J Natl Compr Cancer Netw 4:971–979

    CAS  Google Scholar 

  31. Hunt BR, Whitman S, Hurlbert MS (2014) Increasing Black:white disparities in breast cancer mortality in the 50 largest cities in the United States. Cancer Epidemiol 38:118–123

    Article  PubMed  Google Scholar 

  32. Menashe I, Anderson WF, Jatoi I, Rosenberg PS (2009) Underlying causes of the black-white racial disparity in breast cancer mortality: a population-based analysis. J Natl Cancer Inst 101:993–1000

    Article  PubMed  PubMed Central  Google Scholar 

  33. Schairer C, Mink PJ, Carroll L, Devesa SS (2004) Probabilities of death from breast cancer and other causes among female breast cancer patients. J Natl Cancer Inst 96:1311–1321

    Article  PubMed  Google Scholar 

  34. Gerend MA, Pai M (2008) Social determinants of Black–White disparities in breast cancer mortality: a review. Cancer Epidemiol Biomarkers Prev 17:2913–2923

    Article  PubMed  Google Scholar 

  35. Silber JH, Rosenbaum PR, Clark AS et al (2013) Characteristics associated with differences in survival among black and white women with breast cancer. JAMA 310:389–397

    Article  PubMed  CAS  Google Scholar 

  36. Lepeak L, Tevaarwerk A, Jones N et al (2011) Persistence in breast cancer disparities between African Americans and whites in Wisconsin. WMJ 110:21–25

    PubMed  PubMed Central  Google Scholar 

  37. Jatoi I, Anderson WF, Rao SR, Devesa SS (2005) Breast cancer trends among black and white women in the United States. J Clin Oncol 23:7836–7841

    Article  PubMed  Google Scholar 

  38. DeLancey JOL, Thun MJ, Jemal A, Ward EM (2008) Recent trends in Black–White disparities in cancer mortality. Cancer Epidemiol Biomarkers Prev 17:2908–2912

    Article  PubMed  Google Scholar 

  39. Livaudais JC, Lacroix A, Chlebowski RT et al (2013) Racial/ethnic differences in use and duration of adjuvant hormonal therapy for breast cancer in the women’s health initiative. Cancer Epidemiol Biomarkers Prev 22:365–373

    Article  PubMed  PubMed Central  Google Scholar 

  40. Fedewa SA, Ward EM, Stewart AK, Edge SB (2010) Delays in adjuvant chemotherapy treatment among patients with breast cancer are more likely in African American and Hispanic populations: a national cohort study 2004–2006. J Clin Oncol 28:4135–4141

    Article  PubMed  Google Scholar 

  41. Sail K, Franzini L, Lairson D, Du X (2012) Differences in treatment and survival among African-American and Caucasian women with early stage operable breast cancer. Ethn Health 17:309–323

    Article  PubMed  Google Scholar 

  42. Freedman RA, Hughes ME, Ottesen RA et al (2013) Use of adjuvant trastuzumab in women with human epidermal growth factor receptor 2 (HER2)-positive breast cancer by race/ethnicity and education within the National Comprehensive Cancer Network. Cancer 119:839–846

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  43. Lehtimäki T, Lundin M, Linder N et al (2011) Long-term prognosis of breast cancer detected by mammography screening or other methods. Breast Cancer Res 13:R134

    Article  PubMed  PubMed Central  Google Scholar 

  44. Population Characteristics—SEER registries. Accessed 31 Jan 2013

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This work was supported in part by NCI (N01-PC95001). The dataset used for this analysis was obtained from the Surveillance, Epidemiology, and End Results (SEER) Program Public-Use Data (1992-2008), NCI, Department of Cancer Control and Population Sciences, Surveillance Systems Branch, released April 2014, based on the November 2013 submission. The NCI and SEER program were not involved in the design and conduct of this study, in the analysis or interpretation of the data, or in the preparation and review of this article.

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Correspondence to Lu Chen.

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Chen, L., Linden, H.M., Anderson, B.O. et al. Trends in 5-year survival rates among breast cancer patients by hormone receptor status and stage. Breast Cancer Res Treat 147, 609–616 (2014).

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