Table 2.
Adjusted hazard ratios of subsequent invasive breast cancer classified by laterality and hormone receptor status according to race and ethnicity in women with DCIS in the SEER, 1990 to 2015
| Person-years | All second invasive events† | ER+ or PR+ | ER- and PR- | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Cases | HR†† (95% CI) | Cases | HR†† (95% CI) | Cases | HR†† (95% CI) | ||||
| Subsequent invasive breast cancer‡ | |||||||||
| White | 1018475 | 5884 | 1.00 | 4653 | 1.00 | 821 | 1.00 | ||
| Black | 129931 | 1002 | 1.42 (1.32, 1.52) | 720 | 1.31 (1.21, 1.43) | 190 | 1.86 (1.57, 2.20) | ||
| Asian | 128657 | 807 | 1.08 (0.99, 1.17) | 620 | 1.01 (0.92, 1.11) | 135 | 1.40 (1.14, 1.71) | ||
| Hispanic | 102614 | 640 | 1.09 (1.00, 1.18) | 505 | 1.09 (0.99, 1.20) | 102 | 1.24 (1.00, 1.54) | ||
| Pheterogeneity=0.0004 | |||||||||
| Ipsilateral invasive breast cancer§ | |||||||||
| White | 709275 | 2438 | 1.00 | 1846 | 1.00 | 393 | 1.00 | ||
| Black | 89081 | 478 | 1.65 (1.49, 1.83) | 341 | 1.58 (1.40, 1.78) | 86 | 1.83 (1.43, 2.35) | ||
| Asian | 86294 | 378 | 1.23 (1.09, 1.38) | 286 | 1.19 (1.03, 1.36) | 61 | 1.34 (0.99, 1.81) | ||
| Hispanic | 72785 | 309 | 1.19 (1.05, 1.35) | 235 | 1.20 (1.04, 1.38) | 59 | 1.40 (1.05, 1.87) | ||
| Pheterogeneity=0.57 | |||||||||
| Contralateral invasive breast cancer¶ | |||||||||
| White | 971003 | 3134 | 1.00 | 2556 | 1.00 | 363 | 1.00 | ||
| Black | 126291 | 446 | 1.18 (1.07, 1.31) | 322 | 1.07 (0.95, 1.20) | 92 | 1.97 (1.55, 2.52) | ||
| Asian | 125104 | 396 | 0.97 (0.86, 1.10) | 306 | 0.89 (0.78, 1.02) | 68 | 1.61 (1.20, 2.16) | ||
| Hispanic | 98900 | 292 | 0.98 (0.87, 1.11) | 234 | 0.97 (0.84, 1.11) | 38 | 1.13 (0.80, 1.60) | ||
| Pheterogeneity<.0001 | |||||||||
Abbreviations: ER, estrogen receptor; PR, progesterone receptor; HR, hazard ratio; 95% CI, 95% confidence interval.
Second invasive breast cancer included those positive for ER or PR (ER+ or PR+), those negative for both ER and PR (ER-PR-), and those with no information on ER and PR.
Subsequent invasive breast cancer included ipsilateral invasive breast cancer, contralateral invasive breast cancer, and subsequent metastatic breast cancer.
The analysis included the patients who had been treated with breast-conserving surgery or no surgical treatment for their primary DCIS.
Patients who had received bilateral mastectomy for their primary DCIS were excluded.
Relative risks were adjusted for age (20–39, 40–49, 50–59, 60–69, or ≥70 years) and year of the primary DCIS diagnosis (1990–1999, 2000–2009, or 2010–2015), registry, treatment for primary DCIS (no surgical treatment, breast-conserving surgery alone, breast-conserving surgery followed by radiation therapy, mastectomy, or unknown), histopathological features of primary DCIS including tumor size (<2 cm, 2–5 cm, ≥5 cm or unknown), grade (well differentiated, moderately differentiated, poorly differentiated, or unknown), histology (comedo, papillary, cribriform, solid, or NOS), and hormone receptor expression (positive, negative, or unknown).