Incidence Trends of Breast Cancer Molecular Subtypes by Age and Race/Ethnicity in the US From 2010 to 2016

This cross-sectional study examines the incidence of different molecular subtypes of breast cancers among different racial/ethnic and age groups. Question Are incidence rates of US breast cancer molecular subtypes changing across age and racial/ethnic groups? Findings In this cross-sectional study including 320-124 women diagnosed with breast cancer from 2010 to 2016, incidence rates of luminal A breast cancer increased in non-Hispanic White and Asian/Pacific Islander women aged 40 to 69 years, and in non-Hispanic black women aged 55 to 69 years, for luminal B breast cancer in non-Hispanic White and Hispanic women of all ages, and for ERBB2-enriched breast cancer in non-Hispanic White women aged 25 to 39 years. Incidence rates for triple-negative breast cancer decreased in non-Hispanic Black and non-Hispanic White women aged 40 to 69 years. Meaning These findings of differing breast cancer molecular subtype-specific trends may suggest changes in the prevalence of breast cancer risk factors by race/ethnicity and age. Importance 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. Objective 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. Design, Setting, and Participants 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. Exposures Age and racial/ethnic groups. Main Outcomes and Measures 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. Results 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%). Conclusions and Relevance 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.