title: Lifetime risks of specific breast cancer subtypes among women in four racial/ethnic groups.
abstract: BACKGROUND
  Breast cancer comprises clinically distinct subtypes, but most risk statistics consider breast cancer only as a single entity. To estimate subtype-specific lifetime breast cancer risks, we took advantage of population-based data for which information regarding tumor expression of estrogen receptor (ER), progesterone receptor (PR) and HER2/neu (HER2) was newly available.
  
  
  METHODS
  We included women whose breast cancer was diagnosed in the state of California from 2006 to 2007 and was reported to the National Cancer Institute's Surveillance, Epidemiology and End Results Program (N = 40,936). We calculated absolute lifetime and age-specific probabilities (percent, 95% confidence interval) of developing breast cancer subtypes defined by ER, PR, and HER2 status - luminal (ER and/or PR-positive, HER2-negative), HER2-positive (ER and PR-positive or negative, HER2-positive), and triple-negative (ER-negative, PR-negative, and HER2-negative) - separately for white, black, Hispanic, and Asian women.
  
  
  RESULTS
  The luminal breast cancer subtype predominates across racial/ethnic groups, with lifetime risk lowest in Hispanic women (4.60%, 4.41-4.80%) and highest in white women (8.10%, 7.94-8.20%). HER2-positive breast cancer varies less by race (1.56-1.91%). Lifetime risk of triple-negative breast cancer is highest in black women (1.98%, 1.80-2.17%), compared to 0.77% (0.67-0.88%) for Asians, 1.04% (0.96-1.13%) for Hispanics and 1.25% (1.20-1.30%) for whites. Across racial/ethnic groups, nearly half of all luminal breast cancers occur after age 70.
  
  
  CONCLUSIONS
  These absolute risk estimates may inform health policy and resource planning across diverse populations, and can help patients and physicians weigh the probabilities of developing specific breast cancer subtypes against competing health risks.
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305-5405, USA. akurian@stanford.edu
authors.forename: Allison W
authors.initials: AW
authors.lastname: Kurian
authors.forename: Kari
authors.initials: K
authors.lastname: Fish
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Shema
authors.forename: Christina A
authors.initials: CA
authors.lastname: Clarke
mesh_terms: D044466:Asian People; D014408:Biomarkers, Tumor / Q000032:analysis; D044383:Black People; D001943:Breast Neoplasms / Q000145:classification / Q000453:epidemiology / Q000208:ethnology* / Q000378:metabolism; D002140:California / Q000453:epidemiology; D005260:Female; D020869:Gene Expression Profiling; D006630:Hispanic or Latino; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis; D012307:Risk Factors; D018426:SEER Program; D044465:White People; D001741:Black or African American
chemical_list: D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C508053:ERBB2 protein, human