Disease-free probability after the first primary ductal carcinoma in situ of the breast

A comparison between African-American and White-American women

Azadeh Stark, Robert Stapp, Aditya Raghunathan, Xiaowei Yan, H. Lester Kirchner, Jennifer Griggs, Lisa Newman, Dhananjay Chitale, Andrew Dick

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Compelling evidence about the differences in the biology and behavior of invasive breast cancer between African-American (AA) and White-American (WA) women motivate inquiry into comparing the clinicopathology of non-invasive breast cancer (ductal carcinoma in situ, DCIS). AA and WA women diagnosed with their first primary DCIS between 1990 and 1999 were identified from the institutional tumor registry. Data on method of presentation, treatment, and patient characteristics were retrieved from electronic medical records. Patients were followed up through the medical records until the diagnosis of a subsequent cancer or the last day of contact with the institution. A total of 100 (29.6%) AAs and 236 (70.4%) WAs with the mean age of 60 (SD ± 13) and 57 (SD ± 12), respectively, contributed to this study. DCIS was detected during routine screening mammography for 81% (n = 81) of AAs and 88.4% (n = 206) of WAs (P = 0.073). Differences in the distributions of grade, margin status, necrosis, or treatment modalities were not statistically significant between AAs and WAs. Analysis of competing risks Cox proportional hazard multivariate modeling yielded a significant 8-year cumulative risk of a second cancer for AAs but only in the ipsilateral breast (HR = 3.96, 95% CI 1.42-11.04, P = 0.01). Despite comparable clinical presentation and treatment, 8 years after the initial treatment, AAs experienced a higher risk of second breast cancer in ipsilateral but not in the contralateral breast. The observed excess risk of a second cancer in the ipsilateral breast may suggest of intrinsic differences in the biology of cancer.

Original languageEnglish (US)
Pages (from-to)561-570
Number of pages10
JournalBreast Cancer Research and Treatment
Volume131
Issue number2
DOIs
StatePublished - Jan 1 2012
Externally publishedYes

Fingerprint

Carcinoma, Intraductal, Noninfiltrating
African Americans
Second Primary Neoplasms
Breast
Breast Neoplasms
Neoplasms
Electronic Health Records
Mammography
Therapeutics
Medical Records
Registries
Necrosis

Keywords

  • African-American
  • African-Ancestry
  • Ductal carcinoma in situ
  • Second breast cancer
  • White-American

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Disease-free probability after the first primary ductal carcinoma in situ of the breast : A comparison between African-American and White-American women. / Stark, Azadeh; Stapp, Robert; Raghunathan, Aditya; Yan, Xiaowei; Kirchner, H. Lester; Griggs, Jennifer; Newman, Lisa; Chitale, Dhananjay; Dick, Andrew.

In: Breast Cancer Research and Treatment, Vol. 131, No. 2, 01.01.2012, p. 561-570.

Research output: Contribution to journalArticle

Stark, Azadeh ; Stapp, Robert ; Raghunathan, Aditya ; Yan, Xiaowei ; Kirchner, H. Lester ; Griggs, Jennifer ; Newman, Lisa ; Chitale, Dhananjay ; Dick, Andrew. / Disease-free probability after the first primary ductal carcinoma in situ of the breast : A comparison between African-American and White-American women. In: Breast Cancer Research and Treatment. 2012 ; Vol. 131, No. 2. pp. 561-570.
@article{1b767ca97e09407eb859d4fbeaa8a1fa,
title = "Disease-free probability after the first primary ductal carcinoma in situ of the breast: A comparison between African-American and White-American women",
abstract = "Compelling evidence about the differences in the biology and behavior of invasive breast cancer between African-American (AA) and White-American (WA) women motivate inquiry into comparing the clinicopathology of non-invasive breast cancer (ductal carcinoma in situ, DCIS). AA and WA women diagnosed with their first primary DCIS between 1990 and 1999 were identified from the institutional tumor registry. Data on method of presentation, treatment, and patient characteristics were retrieved from electronic medical records. Patients were followed up through the medical records until the diagnosis of a subsequent cancer or the last day of contact with the institution. A total of 100 (29.6{\%}) AAs and 236 (70.4{\%}) WAs with the mean age of 60 (SD ± 13) and 57 (SD ± 12), respectively, contributed to this study. DCIS was detected during routine screening mammography for 81{\%} (n = 81) of AAs and 88.4{\%} (n = 206) of WAs (P = 0.073). Differences in the distributions of grade, margin status, necrosis, or treatment modalities were not statistically significant between AAs and WAs. Analysis of competing risks Cox proportional hazard multivariate modeling yielded a significant 8-year cumulative risk of a second cancer for AAs but only in the ipsilateral breast (HR = 3.96, 95{\%} CI 1.42-11.04, P = 0.01). Despite comparable clinical presentation and treatment, 8 years after the initial treatment, AAs experienced a higher risk of second breast cancer in ipsilateral but not in the contralateral breast. The observed excess risk of a second cancer in the ipsilateral breast may suggest of intrinsic differences in the biology of cancer.",
keywords = "African-American, African-Ancestry, Ductal carcinoma in situ, Second breast cancer, White-American",
author = "Azadeh Stark and Robert Stapp and Aditya Raghunathan and Xiaowei Yan and Kirchner, {H. Lester} and Jennifer Griggs and Lisa Newman and Dhananjay Chitale and Andrew Dick",
year = "2012",
month = "1",
day = "1",
doi = "10.1007/s10549-011-1742-5",
language = "English (US)",
volume = "131",
pages = "561--570",
journal = "Breast Cancer Research and Treatment",
issn = "0167-6806",
publisher = "Springer New York",
number = "2",

}

TY - JOUR

T1 - Disease-free probability after the first primary ductal carcinoma in situ of the breast

T2 - A comparison between African-American and White-American women

AU - Stark, Azadeh

AU - Stapp, Robert

AU - Raghunathan, Aditya

AU - Yan, Xiaowei

AU - Kirchner, H. Lester

AU - Griggs, Jennifer

AU - Newman, Lisa

AU - Chitale, Dhananjay

AU - Dick, Andrew

PY - 2012/1/1

Y1 - 2012/1/1

N2 - Compelling evidence about the differences in the biology and behavior of invasive breast cancer between African-American (AA) and White-American (WA) women motivate inquiry into comparing the clinicopathology of non-invasive breast cancer (ductal carcinoma in situ, DCIS). AA and WA women diagnosed with their first primary DCIS between 1990 and 1999 were identified from the institutional tumor registry. Data on method of presentation, treatment, and patient characteristics were retrieved from electronic medical records. Patients were followed up through the medical records until the diagnosis of a subsequent cancer or the last day of contact with the institution. A total of 100 (29.6%) AAs and 236 (70.4%) WAs with the mean age of 60 (SD ± 13) and 57 (SD ± 12), respectively, contributed to this study. DCIS was detected during routine screening mammography for 81% (n = 81) of AAs and 88.4% (n = 206) of WAs (P = 0.073). Differences in the distributions of grade, margin status, necrosis, or treatment modalities were not statistically significant between AAs and WAs. Analysis of competing risks Cox proportional hazard multivariate modeling yielded a significant 8-year cumulative risk of a second cancer for AAs but only in the ipsilateral breast (HR = 3.96, 95% CI 1.42-11.04, P = 0.01). Despite comparable clinical presentation and treatment, 8 years after the initial treatment, AAs experienced a higher risk of second breast cancer in ipsilateral but not in the contralateral breast. The observed excess risk of a second cancer in the ipsilateral breast may suggest of intrinsic differences in the biology of cancer.

AB - Compelling evidence about the differences in the biology and behavior of invasive breast cancer between African-American (AA) and White-American (WA) women motivate inquiry into comparing the clinicopathology of non-invasive breast cancer (ductal carcinoma in situ, DCIS). AA and WA women diagnosed with their first primary DCIS between 1990 and 1999 were identified from the institutional tumor registry. Data on method of presentation, treatment, and patient characteristics were retrieved from electronic medical records. Patients were followed up through the medical records until the diagnosis of a subsequent cancer or the last day of contact with the institution. A total of 100 (29.6%) AAs and 236 (70.4%) WAs with the mean age of 60 (SD ± 13) and 57 (SD ± 12), respectively, contributed to this study. DCIS was detected during routine screening mammography for 81% (n = 81) of AAs and 88.4% (n = 206) of WAs (P = 0.073). Differences in the distributions of grade, margin status, necrosis, or treatment modalities were not statistically significant between AAs and WAs. Analysis of competing risks Cox proportional hazard multivariate modeling yielded a significant 8-year cumulative risk of a second cancer for AAs but only in the ipsilateral breast (HR = 3.96, 95% CI 1.42-11.04, P = 0.01). Despite comparable clinical presentation and treatment, 8 years after the initial treatment, AAs experienced a higher risk of second breast cancer in ipsilateral but not in the contralateral breast. The observed excess risk of a second cancer in the ipsilateral breast may suggest of intrinsic differences in the biology of cancer.

KW - African-American

KW - African-Ancestry

KW - Ductal carcinoma in situ

KW - Second breast cancer

KW - White-American

UR - http://www.scopus.com/inward/record.url?scp=84856226834&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84856226834&partnerID=8YFLogxK

U2 - 10.1007/s10549-011-1742-5

DO - 10.1007/s10549-011-1742-5

M3 - Article

VL - 131

SP - 561

EP - 570

JO - Breast Cancer Research and Treatment

JF - Breast Cancer Research and Treatment

SN - 0167-6806

IS - 2

ER -