Molecular Breast Cancer Subtypes in Premenopausal and Postmenopausal African-American Women: Age-Specific Prevalence and Survival
Background Breast cancer is currently regarded as a heterogeneous disease classified into various molecular subtypes using gene expression analysis. These molecular subtypes include: basal cell-like, Her-2/neu, luminal A, and luminal B. Objectives To analyze the prevalence and clinicopathologic asso...
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| creator | Ihemelandu, Chukwuemeka U., M.D Leffall, LaSalle D., M.D Dewitty, Robert L., M.D Naab, Tammey J., M.D Mezghebe, Haile M., M.D Makambi, Kepher H., Ph.D Adams-Campbell, Lucile, Ph.D Frederick, Wayne A., M.D |
| description | Background Breast cancer is currently regarded as a heterogeneous disease classified into various molecular subtypes using gene expression analysis. These molecular subtypes include: basal cell-like, Her-2/neu, luminal A, and luminal B. Objectives To analyze the prevalence and clinicopathologic associations for molecular breast cancer subtypes in premenopausal and postmenopausal African-American women. Design A retrospective analysis of all African-American women diagnosed with breast cancer from 1998 to 2005, who had assessable data for ER, PR, and Her-2/neu status. Molecular subtype classification was done based on immunohistochemical surrogates for ER, PR, and Her-2/neu status obtained from Howard University tumor registry for each patient. The molecular subtypes were defined as: luminal A (ER+ and/or PR+, HER2−), luminal B (ER+ and/or PR+, HER2+), basal-like (ER−, PR−, HER2−), and Her-2/neu (ER−, PR−, and HER2+). Outcome Measures We analyzed the prevalence of molecular breast cancer subtypes in a population of African-American women and determined their associations with patient demographics and clinicopathologic variables: node status, tumor size, histological grade, p53 mutation status, and breast cancer-specific survival. Results The luminal A subtype was the most prevalent in our study sample (55.4%) compared with (11.8%) luminal B, (21.2%) basal cell-like, and (11.6%) Her-2/neu subtypes. The molecular subtypes did not differ by menopausal status. However, when stratified into age-specific groups, the basal cell-like subtype (57.1%) was the most prevalent in the age group |
| doi_str_mv | 10.1016/j.jss.2007.03.085 |
| format | Article |
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These molecular subtypes include: basal cell-like, Her-2/neu, luminal A, and luminal B. Objectives To analyze the prevalence and clinicopathologic associations for molecular breast cancer subtypes in premenopausal and postmenopausal African-American women. Design A retrospective analysis of all African-American women diagnosed with breast cancer from 1998 to 2005, who had assessable data for ER, PR, and Her-2/neu status. Molecular subtype classification was done based on immunohistochemical surrogates for ER, PR, and Her-2/neu status obtained from Howard University tumor registry for each patient. The molecular subtypes were defined as: luminal A (ER+ and/or PR+, HER2−), luminal B (ER+ and/or PR+, HER2+), basal-like (ER−, PR−, HER2−), and Her-2/neu (ER−, PR−, and HER2+). Outcome Measures We analyzed the prevalence of molecular breast cancer subtypes in a population of African-American women and determined their associations with patient demographics and clinicopathologic variables: node status, tumor size, histological grade, p53 mutation status, and breast cancer-specific survival. Results The luminal A subtype was the most prevalent in our study sample (55.4%) compared with (11.8%) luminal B, (21.2%) basal cell-like, and (11.6%) Her-2/neu subtypes. The molecular subtypes did not differ by menopausal status. However, when stratified into age-specific groups, the basal cell-like subtype (57.1%) was the most prevalent in the age group <35 y compared with luminal A, luminal B, and Her-2/neu subtypes at 25.0%, 14.3%, and 3.6%, respectively. The basal cell-like subtype also showed an age-specific bimodal distribution with a peak in the <35 y and 51 to 65 y age groups. The basal cell-like and the Her-2/neu subtypes showed an increased association with clinicopathologic variables portending a more aggressive clinical course when compared with luminal A subtype. A paradoxical inverse relationship between the expression of p53 and Bcl-2 protooncoprotein was noted in the molecular subtypes. Breast cancer-specific survival differed significantly among the molecular subtypes ( P < 0.04), with the basal cell-like and Her-2/neu subtypes having the poorest outcome. Conclusions The high prevalence of the basal cell-like subtype in the young premenopausal African-American women aged <35 y could be a contributory factor to the poorer prognosis of breast cancer observed in this cohort of patients.</description><identifier>ISSN: 0022-4804</identifier><identifier>EISSN: 1095-8673</identifier><identifier>DOI: 10.1016/j.jss.2007.03.085</identifier><identifier>PMID: 17950079</identifier><identifier>CODEN: JSGRA2</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; African Americans ; African-American women ; Age Factors ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Breast Neoplasms - ethnology ; Breast Neoplasms - genetics ; Breast Neoplasms - pathology ; Female ; Gene Expression Regulation, Neoplastic ; General aspects ; Gynecology. Andrology. Obstetrics ; Humans ; Kaplan-Meier Estimate ; Mammary gland diseases ; Medical sciences ; Middle Aged ; molecular breast cancer subtypes ; postmenopausal ; Postmenopause ; premenopausal ; Premenopause ; Prevalence ; Prognosis ; Receptor, ErbB-2 - genetics ; Receptor, ErbB-2 - metabolism ; Receptors, Estrogen - genetics ; Receptors, Estrogen - metabolism ; Receptors, Progesterone - genetics ; Receptors, Progesterone - metabolism ; Retrospective Studies ; Surgery ; Tumors</subject><ispartof>The Journal of surgical research, 2007-11, Vol.143 (1), p.109-118</ispartof><rights>Elsevier Inc.</rights><rights>2007 Elsevier Inc.</rights><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c436t-78d911635c88f87aa0e385e335bd2f82ca29d6ee36905f23c5c5c8b5684935683</citedby><cites>FETCH-LOGICAL-c436t-78d911635c88f87aa0e385e335bd2f82ca29d6ee36905f23c5c5c8b5684935683</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0022480407002466$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>309,310,314,776,780,785,786,3537,23909,23910,25118,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19189532$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17950079$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ihemelandu, Chukwuemeka U., M.D</creatorcontrib><creatorcontrib>Leffall, LaSalle D., M.D</creatorcontrib><creatorcontrib>Dewitty, Robert L., M.D</creatorcontrib><creatorcontrib>Naab, Tammey J., M.D</creatorcontrib><creatorcontrib>Mezghebe, Haile M., M.D</creatorcontrib><creatorcontrib>Makambi, Kepher H., Ph.D</creatorcontrib><creatorcontrib>Adams-Campbell, Lucile, Ph.D</creatorcontrib><creatorcontrib>Frederick, Wayne A., M.D</creatorcontrib><title>Molecular Breast Cancer Subtypes in Premenopausal and Postmenopausal African-American Women: Age-Specific Prevalence and Survival</title><title>The Journal of surgical research</title><addtitle>J Surg Res</addtitle><description>Background Breast cancer is currently regarded as a heterogeneous disease classified into various molecular subtypes using gene expression analysis. These molecular subtypes include: basal cell-like, Her-2/neu, luminal A, and luminal B. Objectives To analyze the prevalence and clinicopathologic associations for molecular breast cancer subtypes in premenopausal and postmenopausal African-American women. Design A retrospective analysis of all African-American women diagnosed with breast cancer from 1998 to 2005, who had assessable data for ER, PR, and Her-2/neu status. Molecular subtype classification was done based on immunohistochemical surrogates for ER, PR, and Her-2/neu status obtained from Howard University tumor registry for each patient. The molecular subtypes were defined as: luminal A (ER+ and/or PR+, HER2−), luminal B (ER+ and/or PR+, HER2+), basal-like (ER−, PR−, HER2−), and Her-2/neu (ER−, PR−, and HER2+). Outcome Measures We analyzed the prevalence of molecular breast cancer subtypes in a population of African-American women and determined their associations with patient demographics and clinicopathologic variables: node status, tumor size, histological grade, p53 mutation status, and breast cancer-specific survival. Results The luminal A subtype was the most prevalent in our study sample (55.4%) compared with (11.8%) luminal B, (21.2%) basal cell-like, and (11.6%) Her-2/neu subtypes. The molecular subtypes did not differ by menopausal status. However, when stratified into age-specific groups, the basal cell-like subtype (57.1%) was the most prevalent in the age group <35 y compared with luminal A, luminal B, and Her-2/neu subtypes at 25.0%, 14.3%, and 3.6%, respectively. The basal cell-like subtype also showed an age-specific bimodal distribution with a peak in the <35 y and 51 to 65 y age groups. The basal cell-like and the Her-2/neu subtypes showed an increased association with clinicopathologic variables portending a more aggressive clinical course when compared with luminal A subtype. A paradoxical inverse relationship between the expression of p53 and Bcl-2 protooncoprotein was noted in the molecular subtypes. Breast cancer-specific survival differed significantly among the molecular subtypes ( P < 0.04), with the basal cell-like and Her-2/neu subtypes having the poorest outcome. Conclusions The high prevalence of the basal cell-like subtype in the young premenopausal African-American women aged <35 y could be a contributory factor to the poorer prognosis of breast cancer observed in this cohort of patients.</description><subject>Adult</subject><subject>African Americans</subject><subject>African-American women</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Breast Neoplasms - ethnology</subject><subject>Breast Neoplasms - genetics</subject><subject>Breast Neoplasms - pathology</subject><subject>Female</subject><subject>Gene Expression Regulation, Neoplastic</subject><subject>General aspects</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Mammary gland diseases</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>molecular breast cancer subtypes</subject><subject>postmenopausal</subject><subject>Postmenopause</subject><subject>premenopausal</subject><subject>Premenopause</subject><subject>Prevalence</subject><subject>Prognosis</subject><subject>Receptor, ErbB-2 - genetics</subject><subject>Receptor, ErbB-2 - metabolism</subject><subject>Receptors, Estrogen - genetics</subject><subject>Receptors, Estrogen - metabolism</subject><subject>Receptors, Progesterone - genetics</subject><subject>Receptors, Progesterone - metabolism</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Tumors</subject><issn>0022-4804</issn><issn>1095-8673</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kl2L1DAUhoMo7rj6A7yR3uhdaz6aNlEQxsFdhRUXRvEyZNJTSc20NacdmEv_uenOwIoXEkhOTt7zJjw5hDxntGCUVa-7okMsOKV1QUVBlXxAVoxqmauqFg_JilLO81LR8oI8Qexo2utaPCYXrNYyVekV-f15CODmYGP2PoLFKdvY3kHMtvNuOo6Ame-z2wh76IfRzmhDZvsmux1w-iu1bqN3ts_Xe7gLsu9DOn2TrX9Avh3B-da7xeVgAyT3O4vtHA8-JZ6SR60NCM_O6yX5dvXh6-ZjfvPl-tNmfZO7UlRTXqtGM1YJ6ZRqVW0tBaEkCCF3DW8Vd5brpgIQlaay5cLJNNROVqrUIs3ikrw6-Y5x-DUDTmbv0UEItodhRpOEjEnOk5CdhC4OiBFaM0a_t_FoGDULd9OZxN0s3A0VJnFPNS_O5vNuD819xRl0Erw8Cyw6G9qYKHu812mmtBTL5W9POkgoDh6iQecXZo2P4CbTDP6_z3j3T7ULvk8_En7CEbAb5tgnxoYZ5Iaa7dIgS3_QOkVlVYk_S4C2BQ</recordid><startdate>20071101</startdate><enddate>20071101</enddate><creator>Ihemelandu, Chukwuemeka U., M.D</creator><creator>Leffall, LaSalle D., M.D</creator><creator>Dewitty, Robert L., M.D</creator><creator>Naab, Tammey J., M.D</creator><creator>Mezghebe, Haile M., M.D</creator><creator>Makambi, Kepher H., Ph.D</creator><creator>Adams-Campbell, Lucile, Ph.D</creator><creator>Frederick, Wayne A., M.D</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20071101</creationdate><title>Molecular Breast Cancer Subtypes in Premenopausal and Postmenopausal African-American Women: Age-Specific Prevalence and Survival</title><author>Ihemelandu, Chukwuemeka U., M.D ; Leffall, LaSalle D., M.D ; Dewitty, Robert L., M.D ; Naab, Tammey J., M.D ; Mezghebe, Haile M., M.D ; Makambi, Kepher H., Ph.D ; Adams-Campbell, Lucile, Ph.D ; Frederick, Wayne A., M.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c436t-78d911635c88f87aa0e385e335bd2f82ca29d6ee36905f23c5c5c8b5684935683</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adult</topic><topic>African Americans</topic><topic>African-American women</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Breast Neoplasms - ethnology</topic><topic>Breast Neoplasms - genetics</topic><topic>Breast Neoplasms - pathology</topic><topic>Female</topic><topic>Gene Expression Regulation, Neoplastic</topic><topic>General aspects</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Mammary gland diseases</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>molecular breast cancer subtypes</topic><topic>postmenopausal</topic><topic>Postmenopause</topic><topic>premenopausal</topic><topic>Premenopause</topic><topic>Prevalence</topic><topic>Prognosis</topic><topic>Receptor, ErbB-2 - genetics</topic><topic>Receptor, ErbB-2 - metabolism</topic><topic>Receptors, Estrogen - genetics</topic><topic>Receptors, Estrogen - metabolism</topic><topic>Receptors, Progesterone - genetics</topic><topic>Receptors, Progesterone - metabolism</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ihemelandu, Chukwuemeka U., M.D</creatorcontrib><creatorcontrib>Leffall, LaSalle D., M.D</creatorcontrib><creatorcontrib>Dewitty, Robert L., M.D</creatorcontrib><creatorcontrib>Naab, Tammey J., M.D</creatorcontrib><creatorcontrib>Mezghebe, Haile M., M.D</creatorcontrib><creatorcontrib>Makambi, Kepher H., Ph.D</creatorcontrib><creatorcontrib>Adams-Campbell, Lucile, Ph.D</creatorcontrib><creatorcontrib>Frederick, Wayne A., M.D</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of surgical research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ihemelandu, Chukwuemeka U., M.D</au><au>Leffall, LaSalle D., M.D</au><au>Dewitty, Robert L., M.D</au><au>Naab, Tammey J., M.D</au><au>Mezghebe, Haile M., M.D</au><au>Makambi, Kepher H., Ph.D</au><au>Adams-Campbell, Lucile, Ph.D</au><au>Frederick, Wayne A., M.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Molecular Breast Cancer Subtypes in Premenopausal and Postmenopausal African-American Women: Age-Specific Prevalence and Survival</atitle><jtitle>The Journal of surgical research</jtitle><addtitle>J Surg Res</addtitle><date>2007-11-01</date><risdate>2007</risdate><volume>143</volume><issue>1</issue><spage>109</spage><epage>118</epage><pages>109-118</pages><issn>0022-4804</issn><eissn>1095-8673</eissn><coden>JSGRA2</coden><abstract>Background Breast cancer is currently regarded as a heterogeneous disease classified into various molecular subtypes using gene expression analysis. These molecular subtypes include: basal cell-like, Her-2/neu, luminal A, and luminal B. Objectives To analyze the prevalence and clinicopathologic associations for molecular breast cancer subtypes in premenopausal and postmenopausal African-American women. Design A retrospective analysis of all African-American women diagnosed with breast cancer from 1998 to 2005, who had assessable data for ER, PR, and Her-2/neu status. Molecular subtype classification was done based on immunohistochemical surrogates for ER, PR, and Her-2/neu status obtained from Howard University tumor registry for each patient. The molecular subtypes were defined as: luminal A (ER+ and/or PR+, HER2−), luminal B (ER+ and/or PR+, HER2+), basal-like (ER−, PR−, HER2−), and Her-2/neu (ER−, PR−, and HER2+). Outcome Measures We analyzed the prevalence of molecular breast cancer subtypes in a population of African-American women and determined their associations with patient demographics and clinicopathologic variables: node status, tumor size, histological grade, p53 mutation status, and breast cancer-specific survival. Results The luminal A subtype was the most prevalent in our study sample (55.4%) compared with (11.8%) luminal B, (21.2%) basal cell-like, and (11.6%) Her-2/neu subtypes. The molecular subtypes did not differ by menopausal status. However, when stratified into age-specific groups, the basal cell-like subtype (57.1%) was the most prevalent in the age group <35 y compared with luminal A, luminal B, and Her-2/neu subtypes at 25.0%, 14.3%, and 3.6%, respectively. The basal cell-like subtype also showed an age-specific bimodal distribution with a peak in the <35 y and 51 to 65 y age groups. The basal cell-like and the Her-2/neu subtypes showed an increased association with clinicopathologic variables portending a more aggressive clinical course when compared with luminal A subtype. A paradoxical inverse relationship between the expression of p53 and Bcl-2 protooncoprotein was noted in the molecular subtypes. Breast cancer-specific survival differed significantly among the molecular subtypes ( P < 0.04), with the basal cell-like and Her-2/neu subtypes having the poorest outcome. Conclusions The high prevalence of the basal cell-like subtype in the young premenopausal African-American women aged <35 y could be a contributory factor to the poorer prognosis of breast cancer observed in this cohort of patients.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>17950079</pmid><doi>10.1016/j.jss.2007.03.085</doi><tpages>10</tpages></addata></record> |
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| subjects | Adult African Americans African-American women Age Factors Aged Aged, 80 and over Biological and medical sciences Breast Neoplasms - ethnology Breast Neoplasms - genetics Breast Neoplasms - pathology Female Gene Expression Regulation, Neoplastic General aspects Gynecology. Andrology. Obstetrics Humans Kaplan-Meier Estimate Mammary gland diseases Medical sciences Middle Aged molecular breast cancer subtypes postmenopausal Postmenopause premenopausal Premenopause Prevalence Prognosis Receptor, ErbB-2 - genetics Receptor, ErbB-2 - metabolism Receptors, Estrogen - genetics Receptors, Estrogen - metabolism Receptors, Progesterone - genetics Receptors, Progesterone - metabolism Retrospective Studies Surgery Tumors |
| title | Molecular Breast Cancer Subtypes in Premenopausal and Postmenopausal African-American Women: Age-Specific Prevalence and Survival |
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