Abstract

Breast cancer incidence trends by age and race/ethnicity have been documented; it is less clear whether incidence trends of breast cancer molecular subtypes, which differ in risk factors and prognosis, also vary by age and race/ethnicity. To estimate annual percentage changes and trends in breast cancer molecular subtype-specific incidence rates by age at diagnosis and race/ethnicity in the US. This population-based cross-sectional study included data from 18 cancer registries in the Surveillance, Epidemiology and End Results database, capturing 27.8% of the US population. Hispanic and non-Hispanic White, Black, and Asian/Pacific Islander women aged 25 to 84 years who were diagnosed with invasive breast cancer from 2010 to 2016 were included. Data were analyzed from September 2019 to February 2020. Age and racial/ethnic groups. Annual percentage change (APC) and 95% CIs for age-standardized breast cancer incidence rates stratified by 15-year age groups at diagnosis and race/ethnicity. Of 320 124 women diagnosed with breast cancer from 2010 to 2016, 232 558 (72.6%) had luminal A, 35 869 (11.2%) had luminal B, 15 472 (4.8%) had ERBB2-enriched, and 36 225 (11.3%) had triple-negative breast cancer subtypes. Luminal A breast cancer incidence rates increased in non-Hispanic White (APC from 2010-2014, 2.3%; 95% CI, 0.3% to 4.2%) and non-Hispanic Asian/Pacific Islander (APC from 2010-2016, 2.5%; 95% CI, 0.6% to 4.5%) women aged 40 to 54 years, and in non-Hispanic Black women aged 55 to 69 years women (APC from 2010-2012, 4.9%; 95% CI, 4.0% to 5.7%). Luminal B breast cancer incidence rates increased in all age groups for non-Hispanic White women (age 25-39 years: APC, 4.3%; 95% CI, 1.5% to 7.%2; age 40-54 years: APC, 3.5%; 95% CI, 1.4% to 5.6%; age 55-69 years: APC, 3.3%; 95% CI, 1.6% to 5.0%; age 70-84 years: APC, 3.9%; 95% CI, 1.9% to 6.0%) and Hispanic women (age 25-39 years: APC, 8.4%; 95% CI, 5.8% to 11.2%; age 40-54 years: APC, 6.1%; 95% CI, 4.2% to 8.0%; age 55-69 years: APC, 5.1%; 95% CI, 1.5% to 8.8%; age 70-84 years: APC, 7.1%; 95% CI, 4.6% to 9.6%) and in non-Hispanic Asian/Pacific Islander women aged 55 to 69 years (APC, 6.1%; 95% CI, 3.2% to 9.0%). ERBB2-enriched breast cancer incidence rates increased in non-Hispanic White women aged 25 to 39 years (APC, 4.7%; 95% CI, 1.5% to 8.0%). Triple-negative breast cancer incidence rates decreased in non-Hispanic White women aged 40 to 54 years (APC, -2.3%; 95% CI, -3.8% to -0.7%) and 55 to 69 years (APC, -3.6%; 95% CI, -5.1% to -2.1%) and in non-Hispanic Black women aged 55 to 69 years (APC, -1.4%; 95% CI, -2.2% to -0.7%). The findings of this cross-sectional study suggest that between 2010 and 2016, luminal A and luminal B breast cancer incidence rates increased for many racial/ethnic and age groups, with the largest increases observed for luminal B breast cancer. ERBB2-enriched breast cancer incidence rates increased for young non-Hispanic White women, while triple-negative breast cancer incidence rates decreased for midlife non-Hispanic White and non-Hispanic Black women. These trends may suggest changes in breast cancer risk factor profiles across age and racial/ethnic groups.

Highlights

  • Luminal A breast cancer incidence rates increased in non-Hispanic White (APC from 2010-2014, 2.3%; 95% CI, 0.3% to 4.2%) and non-Hispanic Asian/ Pacific Islander (APC from 2010-2016, 2.5%; 95% CI, 0.6% to 4.5%) women aged 40 to years, and in non-Hispanic Black women aged to 69 years women (APC from 2010-2012, 4.9%; 95% CI, 4.0% to 5.7%)

  • Luminal B breast cancer incidence rates increased in all age groups for non-Hispanic White women and Hispanic women and in non-Hispanic Asian/Pacific Islander women aged 55 to 69 years (APC, 6.1%; 95% CI, 3.2% to 9.0%)

  • ERBB2-enriched breast cancer incidence rates increased in non-Hispanic White women aged 25 to 39 years (APC, 4.7%; 95% CI, 1.5% to 8.0%)

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Summary

Introduction

Population-based studies suggest a mostly stable trend in overall breast cancer incidence rates,[1,2] there are documented differences in trends by age at diagnosis and racial/ethnic groups.[1,3,4,5] studies have reported racial/ethnic differences in the incidence rates of breast cancer subtypes, defined according to hormone receptor status or ERBB2 (formerly HER2) receptor status, but these studies have mostly considered few broad molecular subtype, race/ethnicity, or age categories.[6,7,8] A 2019 report[2] of temporal changes in breast cancer incidence rates from 2004 through 2016, which used only breast cancer subtypes by hormone receptor status, found that incidence rates increased for hormone receptor–positive breast cancers (corresponding to both luminal A and B molecular breast cancer subtypes) for all races/ethnicities, rates began to stabilized after 2011 for non-Hispanic Black and American Indian and Alaska Native women. Hormone receptor–negative tumors (corresponding to both ERBB2-enriched and triplenegative molecular breast cancer subtypes) decreased for women of all racial/ethnic groups by 1.5% to 2.6% per year. Differences in trends for women by 2 broad age groups (

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