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What can we learn from the age- and race/ethnicity- specific rates of inflammatory breast carcinoma?

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Abstract

Inflammatory Breast Carcinoma (IBC), the most aggressive type of breast tumor with unique clinicopathological presentation, is hypothesized to have distinct etiology with a socioeconomic status (SES) component. Using the Surveillance, Epidemiology and End Results (SEER) Program data for 2004–2007, we compare incidence rates of IBC to non-inflammatory locally advanced breast cancer (LABC) among racial/ethnic groups with different SES. The analysis includes women 20–84 years of age. To examine evidence for the distinct etiology of IBC, we analyzed age-distribution patterns of IBC and non-inflammatory LABC, using a mathematical carcinogenesis model. Based on the Collaborative Staging Extension codes, 2,942 incident IBC cases (codes 71 and 73) and 5,721 non-inflammatory LABC cases (codes 40–62) were identified during the four-year study period. Age-adjusted rates of IBC among non-Hispanic White and Hispanic women were similar (2.5/100,000 in both groups). Similar rates were also found in non-inflammatory LABC in these two groups (4.8/100,000 and 4.2/100,000, respectively). In African-American women, the IBC (3.91/100,000) and non-inflammatory LABC (8.47/100,000) rates were greater compared with other ethnic/racial sub-groups. However, the ratio of rates of IBC/non-inflammatory LABC was similar among all the racial/ethnic groups, suggesting that African-American women are susceptible to aggressive breast tumors in general but not specifically to IBC. The mathematical model successfully predicted the observed age-specific rates of both examined breast tumors and revealed distinct patterns. IBC rates increased until age 65 and then slightly decreased, whereas non-inflammatory LABC rates steadily increased throughout the entire age interval. The number of critical transition carcinogenesis stages (m-stages) predicted by the model were 6.3 and 8.5 for IBC and non-inflammatory LABC, respectively, supporting different etiologies of these breast tumors.

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Fig. 1
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Abbreviations

CI:

Confidence interval

CS extension:

Collaborative staging extension

GDP:

Gross domestic product

IBC:

Inflammatory breast cancer

LABC:

Locally advanced breast cancer

NAACCR:

North American Association of Central Cancer Registries

SEER Program:

Surveillance, Epidemiology and End Results Program

SES:

Socioeconomic status

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Conflict of interest

We have no conflicts of interest to report and have obtained written permission from all acknowledged in the manuscript.

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Authors and Affiliations

  1. Duke Cancer Institute, DUMC Box 2715, Durham, NC, 27710, USA

    Dora Il’yasova

  2. Duke Cancer Institute, DUMC Box 2715, Durham, NC, USA

    Sharareh Siamakpour-Reihani, Lucy Akushevich & Joellen Schildkraut

  3. Duke University Population Research Institute, Box 90408, Durham, NC, USA

    Igor Akushevich

  4. Duke Cancer Institute, DUMC Box 2714, Durham, NC, USA

    Neil Spector

Authors
  1. Dora Il’yasova
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  2. Sharareh Siamakpour-Reihani
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  3. Igor Akushevich
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  4. Lucy Akushevich
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  5. Neil Spector
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  6. Joellen Schildkraut
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Correspondence to Dora Il’yasova.

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Il’yasova, D., Siamakpour-Reihani, S., Akushevich, I. et al. What can we learn from the age- and race/ethnicity- specific rates of inflammatory breast carcinoma?. Breast Cancer Res Treat 130, 691–697 (2011). https://doi.org/10.1007/s10549-011-1719-4

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