Table 3.
Breast cancer-specific and all-cause mortality, for breast cancer overall and by tumor estrogen receptor and progesterone receptor status, stage at diagnosis, and race/ethnicity
| Breast cancer-specific mortality | All-cause mortality | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Cases | Deaths | Model 1 HR (95% CI) 1 |
Model 2 HR (95% CI) 2 |
Model 3 HR (95% CI) 3 |
Deaths | Model 1 HR (95% CI) 1 |
Model 2 HR (95% CI) 2 |
Model 3 HR (95% CI) 3 |
|
| n | n | N | |||||||
| All breast cancer 4 | 12,268 | 1,686 | 3,052 | ||||||
| Non-Hispanic White | 5,245 | 627 | 1.0 | 1.0 | 1.0 | 1,330 | 1.0 | 1.0 | 1.0 |
| Hispanic | 2,596 | 303 | 0.90 (0.76-1.07) | 0.88 (0.74-1.04) | 0.85 (0.70-1.02) | 512 | 0.87 (0.77-0.99) | 0.88 (0.77-1.00) | 0.76 (0.63-0.87) |
| African American | 2,403 | 514 | 1.54 (1.33-1.78) | 1.45 (1.25-1.68) | 1.27 (1.08-1.49) | 853 | 1.44 (1.29-1.60) | 1.38 (1.23-1.54) | 1.11 (0.98-1.25) |
| Asian American | 2,024 | 242 | 0.91 (0.71-1.17) | 0.87 (0.68-1.12) | 0.91 (0.70-1.18) | 357 | 0.83 (0.69-1.02) | 0.81 (0.66-0.99) | 0.84 (0.68-1.03) |
| P < 0.01 | P < 0.01 | P < 0.01 | P < 0.01 | P < 0.01 | P < 0.01 | ||||
| ER+ breast cancer | 7,890 | 920 | 1,827 | ||||||
| Non-Hispanic White | 3,621 | 362 | 1.0 | 1.0 | 1.0 | 861 | 1.0 | 1.0 | 1.0 |
| Hispanic | 1,343 | 254 | 0.86 (0.68-1.09) | 0.83 (0.66-1.06) | 0.83 (0.64-1.07) | 458 | 0.89 (0.75-1.05) | 0.89 (0.75-1.05) | 0.74 (0.62-0.89) |
| African American | 1,656 | 153 | 1.72 (1.42-2.10) | 1.69 (1.39-2.07) | 1.42 (1.13-1.78) | 287 | 1.59 (1.38-1.83) | 1.57 (1.35-1.81) | 1.20 (1.02-1.41) |
| Asian American | 1,270 | 151 | 1.03 (0.76-1.41) | 1.00 (0.73-1.37) | 1.09 (0.79-1.51) | 221 | 0.94 (0.74-1.20) | 0.91 (0.71-1.16) | 0.96 (0.74-1.24) |
| P<0.01 | P<0.01 | P<0.01 | P<0.01 | P<0.01 | P<0.01 | ||||
| ER− breast cancer | 2,521 | 475 | 693 | ||||||
| Non-Hispanic White | 875 | 169 | 1.0 | 1.0 | 1.0 | 252 | 1.0 | 1.0 | 1.0 |
| Hispanic | 648 | 149 | 0.92 (0.67-1.27) | 0.93 (0.67-1.28) | 0.89 (0.62-1.28) | 221 | 0.86 (0.66-1.12) | 0.90 (0.69-1.17) | 0.83 (0.61-1.12) |
| African American | 618 | 103 | 1.07 (0.80-1.42) | 1.13 (0.84-1.51) | 1.00 (0.73-1.37) | 144 | 1.10 (0.87-1.39) | 1.16 (0.91-1.47) | 0.97 (0.75-1.27) |
| Asian American | 380 | 54 | 0.87 (0.53-1.42) | 0.84 (0.51-1.38) | 0.86 (0.51-1.45) | 76 | 0.72 (0.48-1.09) | 0.71 (0.47-1.09) | 0.75 (0.48-1.16) |
| P=0.72 | P=0.47 | P=0.85 | P=0.08 | P=0.05 | P=0.38 | ||||
| PR+ breast cancer | 6,456 | 717 | 1,428 | ||||||
| Non-Hispanic White | 2,944 | 280 | 1.0 | 1.0 | 1.0 | 678 | 1.0 | 1.0 | 1.0 |
| Hispanic | 1,063 | 198 | 0.81 (0.62-1.05) | 0.82 (0.63-1.08) | 0.79 (0.59-1.06) | 347 | 0.87 (0.72-1.05) | 0.90 (0.75-1.09) | 0.74 (0.59-0.91) |
| African American | 1,390 | 121 | 1.54 (1.24-1.92) | 1.54 (1.23-1.93) | 1.30 (1.00-1.68) | 227 | 1.51 (1.29-1.78) | 1.51 (1.28-1.78) | 1.14 (0.95-1.37) |
| Asian American | 1,059 | 118 | 0.98 (0.69-1.38) | 0.95 (0.67-1.35) | 1.03 (0.72-1.49) | 176 | 0.91 (0.69-1.19) | 0.87 (0.66-1.15) | 0.95 (0.71-1.26) |
| P<0.01 | P<0.01 | P<0.01 | P<0.01 | P<0.01 | P<0.01 | ||||
| PR− breast cancer | 3,428 | 625 | 966 | ||||||
| Non-Hispanic White | 1,349 | 235 | 1.0 | 1.0 | 1.0 | 387 | 1.0 | 1.0 | 1.0 |
| Hispanic | 774 | 183 | 0.92 (0.70-1.22) | 0.88 (0.67-1.18) | 0.80 (0.59-1.10) | 281 | 0.86 (0.69-1.08) | 0.86 (0.69-1.08) | 0.76 (0.59-0.98) |
| African American | 821 | 132 | 1.27 (0.99-1.63) | 1.23 (0.96-1.59) | 1.05 (0.79-1.38) | 193 | 1.24 (1.02-1.51) | 1.24 (1.02-1.52) | 1.00 (0.80-1.25) |
| Asian American | 484 | 75 | 0.95 (0.63-1.43) | 0.91 (0.60-1.37) | 0.89 (0.58-1.38) | 105 | 0.87 (0.62-1.23) | 0.85 (0.60-1.21) | 0.83 (0.58-1.19) |
| P=0.06 | P=0.06 | P=0.30 | P<0.01 | P<0.01 | P=0.07 | ||||
| ER/PR+ breast cancer | 8,163 | 964 | 1,890 | ||||||
| Non-Hispanic White | 3,709 | 381 | 1.0 | 1.0 | 1.0 | 888 | 1.0 | 1.0 | 1.0 |
| Hispanic | 1,703 | 161 | 0.85 (0.68-1.07) | 0.84 (0.67-1.06) | 0.84 (0.65-1.08) | 295 | 0.87 (0.74-1.03) | 0.88 (0.75-1.04) | 0.74 (0.61-0.88) |
| African American | 1,419 | 264 | 1.59 (1.31-1.92) | 1.58 (1.30-1.92) | 1.31 (1.05-1.63) | 475 | 1.51 (1.31-1.73) | 1.50 (1.30-1.72) | 1.14 (0.97-1.33) |
| Asian American | 1,332 | 158 | 0.98 (0.73-1.33) | 0.96 (0.71-1.30) | 1.06 (0.77-1.46) | 232 | 0.90 (0.71-1.15) | 0.88 (0.69-1.12) | 0.94 (0.73-1.20) |
| P < 0.01 | P < 0.01 | P < 0.01 | P < 0.01 | P < 0.01 | P < 0.01 | ||||
| Stage I or II | 7,355 | 676 | 1,520 | ||||||
| Non-Hispanic White | 3,388 | 271 | 1.0 | 1.0 | 1.0 | 738 | 1.0 | 1.0 | 1.0 |
| Hispanic | 1,499 | 100 | 0.86 (0.66-1.13) | 0.80 (0.61-1.04) | 0.73 (0.54-0.98) | 217 | 0.88 (0.73-1.05) | 0.87 (0.73-1.05) | 0.70 (0.57-0.86) |
| African American | 1,246 | 189 | 1.84 (1.48-2.29) | 1.63 (1.31-2.04) | 1.27 (0.99-1.62) | 381 | 1.64 (1.41-1.91) | 1.57 (1.35-1.83) | 1.16 (0.97-1.37) |
| Asian American | 1,222 | 116 | 0.93 (0.66-1.31) | 0.85 (0.60-1.21) | 0.94 (0.65-1.35) | 184 | 0.87 (0.67-1.13) | 0.83 (0.63-1.08) | 0.90 (0.68-1.18) |
| P < 0.01 | P < 0.01 | P < 0.01 | P < 0.01 | P < 0.01 | P < 0.01 | ||||
| Stage III or IV | 634 | 263 | 320 | ||||||
| Non-Hispanic White | 240 | 104 | 1.0 | 1.0 | 1.0 | 129 | 1.0 | 1.0 | 1.0 |
| Hispanic | 173 | 54 | 0.87 (0.57-1.33) | 1.04 (0.67-1.62) | 1.23 (0.75-2.02) | 70 | 0.90 (0.61-1.32) | 1.08 (0.72-1.60) | 1.05 (0.67-1.64) |
| African American | 127 | 65 | 1.34 (0.91-1.97) | 1.39 (0.92-2.11) | 1.28 (0.80-2.04) | 75 | 1.27 (0.89-1.82) | 1.27 (0.87-1.86) | 1.04 (0.68-1.61) |
| Asian American | 94 | 40 | 1.03 (0.55-1.92) | 1.08 (0.56-2.08) | 1.04 (0.52-2.08) | 46 | 0.91 (0.50-1.65) | 0.96 (0.51-1.79) | 0.89 (0.46-1.70) |
| P =0.14 | P =0.37 | P =0.74 | P =0.24 | P =0.58 | P =0.97 | ||||
| ER−/PR− breast cancer | 2,203 | 420 | 613 | ||||||
| Non-Hispanic White | 778 | 145 | 1.0 | 1.0 | 1.0 | 220 | 1.0 | 1.0 | 1.0 |
| Hispanic | 560 | 94 | 0.98 (0.69-1.39) | 0.98 (0.69-1.40) | 0.95 (0.64-1.42) | 134 | 0.91 (0.68-1.22) | 0.96 (0.72-1.29) | 0.90 (0.65-1.25) |
| African American | 553 | 135 | 1.25 (0.92-1.70) | 1.29 (0.94-1.77) | 1.16 (0.82-1.64) | 195 | 1.24 (0.96-1.60) | 1.31 (1.01-1.70) | 1.09 (0.82-1.45) |
| Asian American | 312 | 46 | 0.92 (0.55-1.55) | 0.88 (0.52-1.50) | 0.89 (0.51-1.55) | 64 | 0.79 (0.51-1.23) | 0.80 (0.51-1.25) | 0.80 (0.50-1.29) |
| P = 0.29 | P = 0.19 | P = 0.60 | P = 0.03 | P = 0.02 | P = 0.42 | ||||
| Stage I or II | 1,860 | 297 | 462 | ||||||
| Non-Hispanic White | 649 | 100 | 1.0 | 1.0 | 1.0 | 163 | 1.0 | 1.0 | 1.0 |
| Hispanic | 471 | 62 | 1.01 (0.68-1.51) | 1.00 (0.67-1.50) | 0.92 (0.59-1.44) | 97 | 0.91 (0.66-1.25) | 1.00 (0.72-1.38) | 0.86 (0.60-1.23) |
| African American | 463 | 101 | 1.51 (1.08-2.12) | 1.45 (1.03-2.05) | 1.27 (0.86-1.86) | 153 | 1.38 (1.05-1.81) | 1.45 (1.10-1.91) | 1.13 (0.83-1.55) |
| Asian American | 277 | 34 | 0.96 (0.55-1.69) | 0.91 (0.51-1.62) | 0.93 (0.50-1.72) | 49 | 0.78 (0.49-1.25) | 0.85 (0.52-1.38) | 0.87 (0.52-1.45) |
| P = 0.03 | P = 0.06 | P = 0.34 | P < 0.01 | P < 0.01 | P = 0.30 | ||||
| Stage III or IV | 285 | 113 | 131 | ||||||
| Non-Hispanic White | 106 | 43 | 1.0 | 1.0 | 1.0 | 48 | 1.0 | 1.0 | 1.0 |
| Hispanic | 77 | 28 | 0.95 (0.48-1.88) | 1.09 (0.52-2.28) | 1.20 (0.46-3.09) | 33 | 0.91 (0.66-1.25) | 1.25 (0.63-2.49) | 1.35 (0.55-3.34) |
| African American | 70 | 30 | 1.10 (0.58-2.08) | 1.26 (0.61-2.62) | 1.02 (0.42-2.48) | 35 | 1.05 (0.55-2.00) | 1.27 (0.64-2.52) | 0.92 (0.40-2.11) |
| Asian American | 32 | 12 | 0.66 (0.20-2.11) | 0.62 (0.18-2.20) | 0.54 (0.11-2.68) | 15 | 0.80 (0.28-2.32) | 0.67 (0.22-2.08) | 0.46 (0.11-1.95) |
| P = 0.84 | P = 0.71 | P = 0.84 | P = 0.85 | P = 0.64 | P = 0.56 | ||||
Abbreviations: AJCC, American Joint Committee on Cancer; BMI, body mass index; CCR, California Cancer Registry; CI, confidence interval; ER/PR+, estrogen receptor-positive or progesterone receptor-positive; ER−/PR−, estrogen receptor-negative and progesterone receptor-negative; HR, hazard ratio; NHW, non-Hispanic white; SES, socioeconomic status.
Model 1 used delayed entry Cox proportional hazards regression with attained age (days) as the time scale. Entry date into the risk set is the later of date of questionnaire completion or date of BC diagnosis. The exit date is earliest of date of death, last follow-up date in CCR, or December 31, 2010. The Cox model was stratified by study (AABCS, CARE, CTS, MEC, NC-BCFR, SFBCS) and AJCC stage (I, II, III, IV, unknown) and included age at diagnosis (years), log transformed age at diagnosis, and year of diagnosis.
Model 2 included Model 1 variables and histology (ductal, lobular, other), grade (I, II, III/IV, unknown), nodal involvement (no, yes, unknown), availability of tumor size as continuous measure (yes, no) and tumor size (continuous), diagnoses of subsequent cancers (yes, no), time between diagnoses of subsequent tumors (days), surgery type (none, mastectomy, breast conserving surgery, other), radiation therapy (yes, no), and chemotherapy (yes, no, unknown).
Model 3 included Model 2 variables and marital status at diagnosis (single or never married, married, separated or divorced, widowed, unknown), education (some high school or less, high school graduate, some college or technical school, college graduate or higher degree, unknown), neighborhood SES at diagnosis (quintiles, unknown), number of full-term pregnancies (nulliparous, 1, 2, 3, ≥4, unknown), BMI (<25, 25-29.9, ≥30 kg/m2, unknown) in year before diagnosis (case-control studies) or within 6 months of diagnosis (cohort studies), pre-diagnosis smoking history (never, past, current, unknown), and alcohol consumption (0, ≤2, >2 drinks per week, unknown) in year before diagnosis (case-control studies) or within 6 months of diagnosis (cohort studies).
Includes all women regardless of ER or PR status.