Scientists assess probability of death from breast cancer

AORN Journal, Oct, 2004

Women who are diagnosed with breast cancer at a young age or at an advanced stage of breast cancer at any age are more likely to die from the cancer than from art other causes of death combined, according to an Aug 31, 2004, news release from the National Institutes of Health (NIH). A new study by scientists at the National Cancer Institute (NCI), part of the NIH, reports that the probability of death from breast cancer varies significantly according to stage, tumor size, estrogen receptor (ER) status, and age at diagnosis in both African American and Caucasian patients.

To calculate the probabilities of death from breast cancer versus all other causes combined among breast cancer patients, researchers analyzed data from NCI's Surveillance, Epidemiology and End Results program for more than 400,000 patients who were diagnosed with breast cancer between 1973 and 2000. They calculated probabilities of death from breast cancer and all other causes combined during a 28-year follow-up period according to stage and age at diagnosis and during an 11-year follow-up period according to tumor size and ER status for a subset of patients.

The researchers found that patients with breast cancer who had ER-negative tumors were more likely to die from the cancer than patients with ER-positive tumors. Additionally, patients with larger tumors were more likely to die from the cancer than were patients with smatter tumors.

The probability of death from breast cancer was greater than that from all other causes for patients who were diagnosed with localized breast cancer when they were younger than 50 years of age. The same is true for patients diagnosed with localized breast cancer before age 60 or with distant disease (ie, cancer that has spread to distant organs or distant lymph nodes) at any age.

As age at breast cancer diagnosis increased, the risk of death from other causes increased, and the risk of death from breast cancer generally decreased. Even among older patients, however, breast cancer still accounted for significant mortality.

The researchers also found that mortality from breast cancer generally was higher in African American patients than in Caucasian patients. According to the researchers, these results are consistent with those of other analyses that have shown generally poorer breast cancer survival in African American patients than in Caucasian patients. The NCI researchers suggest that this may be due to differences in treatment and to a higher prevalence of obesity and obesity-related health conditions in African American patients, among other factors.

Scientists Estimate Probability of Death From Breast Cancer and Other Causes Following Diagnosis (news release, Bethesda, Md: National Institutes of Health, Aug 31, 2004) http://www.nih.gov/news/pr/aug2004/nci -31_.htm (accessed 31 Aug 2004).