Race/ethnicity, genetic ancestry, and breast cancer-related lymphedema in the Pathways Study.
Identifieur interne : 000683 ( PubMed/Checkpoint ); précédent : 000682; suivant : 000684Race/ethnicity, genetic ancestry, and breast cancer-related lymphedema in the Pathways Study.
Auteurs : Marilyn L. Kwan [États-Unis] ; Song Yao [États-Unis] ; Valerie S. Lee [États-Unis] ; Janise M. Roh [États-Unis] ; Qianqian Zhu [États-Unis] ; Isaac J. Ergas [États-Unis] ; Qian Liu [États-Unis] ; Yali Zhang [États-Unis] ; Susan E. Kutner [États-Unis] ; Charles P. Quesenberry [États-Unis] ; Christine B. Ambrosone [États-Unis] ; Lawrence H. Kushi [États-Unis]Source :
- Breast cancer research and treatment [ 1573-7217 ] ; 2016.
Abstract
Breast cancer-related lymphedema (BCRL) is a serious chronic condition after breast cancer (BC) surgery and treatment. It is unclear if BCRL risk varies by race/ethnicity. In a multiethnic prospective cohort study of 2953 BC patients, we examined the association of self-reported BCRL status with self-reported race/ethnicity and estimated genetic ancestry. Hazard ratios (HR) and 95 % confidence intervals (CI) were calculated by multivariable Cox proportional hazards models, with follow-up starting 6 months post-BC diagnosis. Estimates were further stratified by body mass index (BMI). By 48 months of follow-up, 342 (11.6 %) women reported having BCRL. Younger age at BC diagnosis, higher BMI at baseline, and lower physical activity were associated with greater BCRL risk. African American (AA) women had a 2-fold increased risk of BCRL compared with White women (HR = 2.04; 95 % CI 1.35-3.08). African genetic ancestry was also associated with an increased risk (HR = 2.50; 95 % CI 1.43, 4.36). Both risks were attenuated but remained elevated after adjusting for known risk factors and became more pronounced when restricted to the nonobese women (adjusted HR = 2.31 for AA and HR = 3.70 for African ancestry, both p < 0.05). There was also evidence of increased BCRL risk with Hispanic ethnicity in the nonobese women. Nonobese AA women had a higher risk of BCRL than White women, which cannot be fully explained by known risk factors. This is the first large-scale, prospective study demonstrating differences in BCRL risk according to race/ethnicity as assessed by both self-report and genetic ancestry data, with a potential ancestry-obesity interaction.
DOI: 10.1007/s10549-016-3913-x
PubMed: 27449493
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Kwan</name><affiliation wicri:level="1"><nlm:affiliation>Division of Research, Kaiser Permanente Northern California, Oakland, CA, 94612, USA. 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Roh</name><affiliation wicri:level="1"><nlm:affiliation>Division of Research, Kaiser Permanente Northern California, Oakland, CA, 94612, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Research, Kaiser Permanente Northern California, Oakland, CA, 94612</wicri:regionArea><wicri:noRegion>94612</wicri:noRegion></affiliation></author><author><name sortKey="Zhu, Qianqian" sort="Zhu, Qianqian" uniqKey="Zhu Q" first="Qianqian" last="Zhu">Qianqian Zhu</name><affiliation wicri:level="2"><nlm:affiliation>Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, 14263, NY, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, 14263, NY</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Ergas, Isaac J" sort="Ergas, Isaac J" uniqKey="Ergas I" first="Isaac J" last="Ergas">Isaac J. Ergas</name><affiliation wicri:level="1"><nlm:affiliation>Division of Research, Kaiser Permanente Northern California, Oakland, CA, 94612, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Research, Kaiser Permanente Northern California, Oakland, CA, 94612</wicri:regionArea><wicri:noRegion>94612</wicri:noRegion></affiliation></author><author><name sortKey="Liu, Qian" sort="Liu, Qian" uniqKey="Liu Q" first="Qian" last="Liu">Qian Liu</name><affiliation wicri:level="2"><nlm:affiliation>Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, 14263, NY, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, 14263, NY</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Zhang, Yali" sort="Zhang, Yali" uniqKey="Zhang Y" first="Yali" last="Zhang">Yali Zhang</name><affiliation wicri:level="2"><nlm:affiliation>Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, 14263, NY, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, 14263, NY</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Kutner, Susan E" sort="Kutner, Susan E" uniqKey="Kutner S" first="Susan E" last="Kutner">Susan E. Kutner</name><affiliation wicri:level="2"><nlm:affiliation>San Jose Medical Center, Kaiser Permanente Northern California, San Jose, 95119, CA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>San Jose Medical Center, Kaiser Permanente Northern California, San Jose, 95119, CA</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Quesenberry, Charles P" sort="Quesenberry, Charles P" uniqKey="Quesenberry C" first="Charles P" last="Quesenberry">Charles P. Quesenberry</name><affiliation wicri:level="1"><nlm:affiliation>Division of Research, Kaiser Permanente Northern California, Oakland, CA, 94612, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Research, Kaiser Permanente Northern California, Oakland, CA, 94612</wicri:regionArea><wicri:noRegion>94612</wicri:noRegion></affiliation></author><author><name sortKey="Ambrosone, Christine B" sort="Ambrosone, Christine B" uniqKey="Ambrosone C" first="Christine B" last="Ambrosone">Christine B. Ambrosone</name><affiliation wicri:level="2"><nlm:affiliation>Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, 14263, NY, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, 14263, NY</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Kushi, Lawrence H" sort="Kushi, Lawrence H" uniqKey="Kushi L" first="Lawrence H" last="Kushi">Lawrence H. Kushi</name><affiliation wicri:level="1"><nlm:affiliation>Division of Research, Kaiser Permanente Northern California, Oakland, CA, 94612, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Research, Kaiser Permanente Northern California, Oakland, CA, 94612</wicri:regionArea><wicri:noRegion>94612</wicri:noRegion></affiliation></author></analytic><series><title level="j">Breast cancer research and treatment</title><idno type="eISSN">1573-7217</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Breast cancer-related lymphedema (BCRL) is a serious chronic condition after breast cancer (BC) surgery and treatment. It is unclear if BCRL risk varies by race/ethnicity. In a multiethnic prospective cohort study of 2953 BC patients, we examined the association of self-reported BCRL status with self-reported race/ethnicity and estimated genetic ancestry. Hazard ratios (HR) and 95 % confidence intervals (CI) were calculated by multivariable Cox proportional hazards models, with follow-up starting 6 months post-BC diagnosis. Estimates were further stratified by body mass index (BMI). By 48 months of follow-up, 342 (11.6 %) women reported having BCRL. Younger age at BC diagnosis, higher BMI at baseline, and lower physical activity were associated with greater BCRL risk. African American (AA) women had a 2-fold increased risk of BCRL compared with White women (HR = 2.04; 95 % CI 1.35-3.08). African genetic ancestry was also associated with an increased risk (HR = 2.50; 95 % CI 1.43, 4.36). Both risks were attenuated but remained elevated after adjusting for known risk factors and became more pronounced when restricted to the nonobese women (adjusted HR = 2.31 for AA and HR = 3.70 for African ancestry, both p < 0.05). There was also evidence of increased BCRL risk with Hispanic ethnicity in the nonobese women. Nonobese AA women had a higher risk of BCRL than White women, which cannot be fully explained by known risk factors. This is the first large-scale, prospective study demonstrating differences in BCRL risk according to race/ethnicity as assessed by both self-report and genetic ancestry data, with a potential ancestry-obesity interaction.</div></front></TEI><pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">27449493</PMID><DateCreated><Year>2016</Year><Month>09</Month><Day>03</Day></DateCreated><DateRevised><Year>2017</Year><Month>08</Month><Day>01</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1573-7217</ISSN><JournalIssue CitedMedium="Internet"><Volume>159</Volume><Issue>1</Issue><PubDate><Year>2016</Year><Month>Aug</Month></PubDate></JournalIssue><Title>Breast cancer research and treatment</Title><ISOAbbreviation>Breast Cancer Res. Treat.</ISOAbbreviation></Journal><ArticleTitle>Race/ethnicity, genetic ancestry, and breast cancer-related lymphedema in the Pathways Study.</ArticleTitle><Pagination><MedlinePgn>119-29</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1007/s10549-016-3913-x</ELocationID><Abstract><AbstractText>Breast cancer-related lymphedema (BCRL) is a serious chronic condition after breast cancer (BC) surgery and treatment. It is unclear if BCRL risk varies by race/ethnicity. In a multiethnic prospective cohort study of 2953 BC patients, we examined the association of self-reported BCRL status with self-reported race/ethnicity and estimated genetic ancestry. Hazard ratios (HR) and 95 % confidence intervals (CI) were calculated by multivariable Cox proportional hazards models, with follow-up starting 6 months post-BC diagnosis. Estimates were further stratified by body mass index (BMI). By 48 months of follow-up, 342 (11.6 %) women reported having BCRL. Younger age at BC diagnosis, higher BMI at baseline, and lower physical activity were associated with greater BCRL risk. African American (AA) women had a 2-fold increased risk of BCRL compared with White women (HR = 2.04; 95 % CI 1.35-3.08). African genetic ancestry was also associated with an increased risk (HR = 2.50; 95 % CI 1.43, 4.36). Both risks were attenuated but remained elevated after adjusting for known risk factors and became more pronounced when restricted to the nonobese women (adjusted HR = 2.31 for AA and HR = 3.70 for African ancestry, both p < 0.05). There was also evidence of increased BCRL risk with Hispanic ethnicity in the nonobese women. Nonobese AA women had a higher risk of BCRL than White women, which cannot be fully explained by known risk factors. This is the first large-scale, prospective study demonstrating differences in BCRL risk according to race/ethnicity as assessed by both self-report and genetic ancestry data, with a potential ancestry-obesity interaction.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Kwan</LastName><ForeName>Marilyn L</ForeName><Initials>ML</Initials><AffiliationInfo><Affiliation>Division of Research, Kaiser Permanente Northern California, Oakland, CA, 94612, USA. Marilyn.L.Kwan@kp.org.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yao</LastName><ForeName>Song</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, 14263, NY, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lee</LastName><ForeName>Valerie S</ForeName><Initials>VS</Initials><AffiliationInfo><Affiliation>Division of Research, Kaiser Permanente Northern California, Oakland, CA, 94612, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Roh</LastName><ForeName>Janise M</ForeName><Initials>JM</Initials><AffiliationInfo><Affiliation>Division of Research, Kaiser Permanente Northern California, Oakland, CA, 94612, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zhu</LastName><ForeName>Qianqian</ForeName><Initials>Q</Initials><AffiliationInfo><Affiliation>Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, 14263, NY, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ergas</LastName><ForeName>Isaac J</ForeName><Initials>IJ</Initials><AffiliationInfo><Affiliation>Division of Research, Kaiser Permanente Northern California, Oakland, CA, 94612, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Liu</LastName><ForeName>Qian</ForeName><Initials>Q</Initials><AffiliationInfo><Affiliation>Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, 14263, NY, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zhang</LastName><ForeName>Yali</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, 14263, NY, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kutner</LastName><ForeName>Susan E</ForeName><Initials>SE</Initials><AffiliationInfo><Affiliation>San Jose Medical Center, Kaiser Permanente Northern California, San Jose, 95119, CA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Quesenberry</LastName><ForeName>Charles P</ForeName><Initials>CP</Initials><Suffix>Jr</Suffix><AffiliationInfo><Affiliation>Division of Research, Kaiser Permanente Northern California, Oakland, CA, 94612, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ambrosone</LastName><ForeName>Christine B</ForeName><Initials>CB</Initials><AffiliationInfo><Affiliation>Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, 14263, NY, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kushi</LastName><ForeName>Lawrence H</ForeName><Initials>LH</Initials><AffiliationInfo><Affiliation>Division of Research, Kaiser Permanente Northern California, Oakland, CA, 94612, USA.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>P30 CA016056</GrantID><Acronym>CA</Acronym><Agency>NCI NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R01 CA105274</GrantID><Acronym>CA</Acronym><Agency>NCI NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>U01 CA195565</GrantID><Acronym>CA</Acronym><Agency>NCI NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2016</Year><Month>07</Month><Day>22</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>Breast Cancer Res Treat</MedlineTA><NlmUniqueID>8111104</NlmUniqueID><ISSNLinking>0167-6806</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections 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PubStatus="accepted"><Year>2016</Year><Month>07</Month><Day>14</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2016</Year><Month>7</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2016</Year><Month>7</Month><Day>28</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2016</Year><Month>7</Month><Day>28</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">27449493</ArticleId><ArticleId IdType="doi">10.1007/s10549-016-3913-x</ArticleId><ArticleId IdType="pii">10.1007/s10549-016-3913-x</ArticleId><ArticleId IdType="pmc">PMC5010992</ArticleId><ArticleId IdType="mid">NIHMS805457</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>États-Unis</li></country><region><li>Californie</li><li>État de New York</li></region></list><tree><country name="États-Unis"><noRegion><name sortKey="Kwan, Marilyn L" sort="Kwan, Marilyn L" uniqKey="Kwan M" first="Marilyn L" last="Kwan">Marilyn L. Kwan</name></noRegion><name sortKey="Ambrosone, Christine B" sort="Ambrosone, Christine B" uniqKey="Ambrosone C" first="Christine B" last="Ambrosone">Christine B. Ambrosone</name><name sortKey="Ergas, Isaac J" sort="Ergas, Isaac J" uniqKey="Ergas I" first="Isaac J" last="Ergas">Isaac J. Ergas</name><name sortKey="Kushi, Lawrence H" sort="Kushi, Lawrence H" uniqKey="Kushi L" first="Lawrence H" last="Kushi">Lawrence H. Kushi</name><name sortKey="Kutner, Susan E" sort="Kutner, Susan E" uniqKey="Kutner S" first="Susan E" last="Kutner">Susan E. Kutner</name><name sortKey="Lee, Valerie S" sort="Lee, Valerie S" uniqKey="Lee V" first="Valerie S" last="Lee">Valerie S. Lee</name><name sortKey="Liu, Qian" sort="Liu, Qian" uniqKey="Liu Q" first="Qian" last="Liu">Qian Liu</name><name sortKey="Quesenberry, Charles P" sort="Quesenberry, Charles P" uniqKey="Quesenberry C" first="Charles P" last="Quesenberry">Charles P. Quesenberry</name><name sortKey="Roh, Janise M" sort="Roh, Janise M" uniqKey="Roh J" first="Janise M" last="Roh">Janise M. Roh</name><name sortKey="Yao, Song" sort="Yao, Song" uniqKey="Yao S" first="Song" last="Yao">Song Yao</name><name sortKey="Zhang, Yali" sort="Zhang, Yali" uniqKey="Zhang Y" first="Yali" last="Zhang">Yali Zhang</name><name sortKey="Zhu, Qianqian" sort="Zhu, Qianqian" uniqKey="Zhu Q" first="Qianqian" last="Zhu">Qianqian Zhu</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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