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Showing content from https://pubmed.ncbi.nlm.nih.gov/24149174/ below:

Ethnicity and outcome of young breast cancer patients in the United Kingdom: the POSH study

Multicenter Study

Collaborators, Affiliations

• POSH study steering group: Diana Eccles, Peter Simmonds, Douglas G Altman, Paul Pharoah, Louise Jones, Ros Eeles, Gareth Evans, Alistair Thompson, Shirley Hodgson, Hisham Hammad, Tim Bishop, Ruth Warren, Fiona Gilbert, Sunil Lakhani, Andrew Hanby

• ¹ Cancer Sciences Academic Unit and University of Southampton Clinical Trials Unit, Faculty of Medicine, University of Southampton and University Hospital Southampton Foundation Trust, Tremona Road, Southampton SO16 6YA, UK.
• ² Centre for Statistics in Medicine, Wolfson College Annexe, Oxford OX2 6UD, UK.
• ³ Tumour Biology Department, Institute of Cancer, Barts & The London School of Medicine & Dentistry, Charterhouse Square, London, EC1M 6BQ, UK.

• PMID: 24149174
• PMCID: PMC3887284
• DOI: 10.1038/bjc.2013.650

Item in Clipboard

Multicenter Study

E Copson et al. Br J Cancer. 2014.

• POSH study steering group: Diana Eccles, Peter Simmonds, Douglas G Altman, Paul Pharoah, Louise Jones, Ros Eeles, Gareth Evans, Alistair Thompson, Shirley Hodgson, Hisham Hammad, Tim Bishop, Ruth Warren, Fiona Gilbert, Sunil Lakhani, Andrew Hanby

• ¹ Cancer Sciences Academic Unit and University of Southampton Clinical Trials Unit, Faculty of Medicine, University of Southampton and University Hospital Southampton Foundation Trust, Tremona Road, Southampton SO16 6YA, UK.
• ² Centre for Statistics in Medicine, Wolfson College Annexe, Oxford OX2 6UD, UK.
• ³ Tumour Biology Department, Institute of Cancer, Barts & The London School of Medicine & Dentistry, Charterhouse Square, London, EC1M 6BQ, UK.

• PMID: 24149174
• PMCID: PMC3887284
• DOI: 10.1038/bjc.2013.650

Item in Clipboard

Background: Black ethnic groups have a higher breast cancer mortality than Whites. American studies have identified variations in tumour biology and unequal health-care access as causative factors. We compared tumour pathology, treatment and outcomes in three ethnic groups in young breast cancer patients treated in the United Kingdom.

Methods: Women aged ≤ 40 years at breast cancer diagnosis were recruited to the POSH national cohort study (MREC: 00/06/69). Personal characteristics, tumour pathology and treatment data were collected at diagnosis. Follow-up data were collected annually. Overall survival (OS) and distant relapse-free survival (DRFS) were assessed using Kaplan-Meier curves, and multivariate analyses were performed using Cox regression.

Results: Ethnicity data were available for 2915 patients including 2690 (91.0%) Whites, 118 (4.0%) Blacks and 87 (2.9%) Asians. Median tumour diameter at presentation was greater in Blacks than Whites (26.0 mm vs 22.0 mm, P=0.0103), and multifocal tumours were more frequent in both Blacks (43.4%) and Asians (37.0%) than Whites (28.9%). ER/PR/HER2-negative tumours were significantly more frequent in Blacks (26.1%) than Whites (18.6%, P=0.043). Use of chemotherapy was similarly high in all ethnic groups (89% B vs 88.6% W vs 89.7% A). A 5-year DRFS was significantly lower in Blacks than Asians (62.8% B vs 77.0% A, P=0.0473) or Whites (62.8 B% vs 77.0% W, P=0.0053) and a 5-year OS for Black patients, 71.1% (95% CI: 61.0-79.1%), was significantly lower than that of Whites (82.4%, 95% CI: 80.8-83.9%, W vs B: P=0.0160). In multivariate analysis, Black ethnicity had an effect on DRFS in oestrogen receptor (ER)-positive patients that is independent of body mass index, tumour size, grade or nodal status, HR: 1.60 (95% CI: 1.03-2.47, P=0.035).

Conclusion: Despite equal access to health care, young Black women in the United Kingdom have a significantly poorer outcome than White patients. Black ethnicity is an independent risk factor for reduced DRFS particularly in ER-positive patients.

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Flow Diagram for the Prospective…

Flow Diagram for the Prospective Study of Outcomes in Sporadic and Hereditary Breast…

Flow Diagram for the Prospective Study of Outcomes in Sporadic and Hereditary Breast Cancer (POSH).

Kaplan–Meier ( A ) OS…

Kaplan–Meier ( A ) OS and ( B ) DRFS estimates for Caucasian/White,…

Kaplan–Meier (A) OS and (B) DRFS estimates for Caucasian/White, Black and Asian patients.

Kaplan–Meier DRFS estimates for Caucasian/White,…

Kaplan–Meier DRFS estimates for Caucasian/White, Black and Asian ( A ) ER-negative patients…

Kaplan–Meier DRFS estimates for Caucasian/White, Black and Asian (A) ER-negative patients and (B) ER-positive patients.

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