Death risk in breast cancer patients can vary widely

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In women with breast cancer, the probability of dying from that malignancy, as opposed to some other cause, can range from 3 percent to 85 percent, depending on factors such as disease stage and patient age at diagnosis, new research shows.

“To our knowledge, this is the first comprehensive competing-risk analysis to quantify the probability of death from breast cancer and other causes after a diagnosis of breast cancer,” Dr. Catherine Schairer, from the National Cancer Institute in Rockville, Maryland, and colleagues note in the Journal of the National Cancer Institute for September 1.

The findings are based on an analysis of data from breast cancer patients entered in the Surveillance, Epidemiology, and End Results (SEER) Program, a large national database. The investigators determined the survival rates, and classified any deaths as either from breast cancer or other causes, for more than 395,000 white and 35,000 black women diagnosed with breast cancer between 1973 and 2000.

For women with early-stage disease, the probability of death from breast cancer ranged from 3 percent to 10 percent, depending on age and race. In contrast, in patients with late-stage disease, the probability ranged from 70 percent to 85 percent.

In women with early- or late-stage disease, the probability of death from breast cancer was higher for subjects diagnosed before 50 years of age compared with those diagnosed at age 70 years or older. This was observed in black and white patients.

Regardless of age, patients with late-stage disease were more likely to die from their cancer than from all other causes. In contrast, for women with localized or regional disease, death from breast cancer only outweighed other causes when it was diagnosed before age 50 and 60 years, respectively.

For localized or regional disease, the probability of death from breast cancer was higher for black than for white patients, the investigators point out.

Patients with estrogen receptor-negative tumors were more likely to die from their disease than were those with estrogen receptor-positive tumors, they add.

“The probability of death from breast cancer versus other causes varied substantially according to stage, tumor size, estrogen-receptor status, and age at diagnosis in both white and black patients,” the researchers conclude.

SOURCE: Journal of the National Cancer Institute, September 1, 2004.

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