ArticleBreast cancer research and treatment2020
Bimodal age distribution at diagnosis in breast cancer persists across molecular and genomic classifications.
Article in Breast cancer research and treatment, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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20 citing papers in PubMed.
- Clinical outcomes of sacituzumab govitecan in older patients with metastatic triple-negative breast cancer: a multinational real-world study.The oncologist · 2026Article
- Postpartum breast cancer: evidence for a distinct phenotype.Journal of the National Cancer Institute · 2026Article
- Age-related genomic characterization and therapeutic targets in Chinese breast cancer: insights from prospective targeted sequencing and clinical data analysis.BMC medicine · 2026Article
- Mitochondria-nucleus communication dictates progressive versus bimodal aging of the mammary gland.bioRxiv : the preprint server for biology · 2026Article
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- Bioinformatic Approach to Identify Positive PrognosticInternational journal of molecular sciences · 2025Article
- Human Papillomavirus and Other Relevant Issues in Cervical Cancer Pathogenesis.International journal of molecular sciences · 2025Review
- Male Breast Cancer Brain Metastases: Genetic Profiles and Radiosurgery Outcomes.Neurosurgery practice · 2025Article
- Effects of taxane-anthracycline and taxane only treatment on cardiac function in breast cancer-a retrospective cohort study.Cardio-oncology (London, England) · 2025Article
- Breast cancer risk assessment based on a predictive model: evaluation of risk factors among Japanese women.BMC cancer · 2025Article
- Maternal ancestry reveals cyclical aging of the mammary gland.Research square · 2024Article
- The Cancer Spectrum Theory.Cancer discovery · 2024Article
- Host, reproductive, and lifestyle factors in relation to quantitative histologic metrics of the normal breast.Breast cancer research : BCR · 2023Article
- Deep Transcriptome Profiling of Multiple Myeloma Using Quantitative Phenotypes.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2023Article
- Characteristics of female breast cancer in japan: annual report of the National Clinical Database in 2018.Breast cancer (Tokyo, Japan) · 2023Article
- Intrinsic subtypes in Ethiopian breast cancer patient.Breast cancer research and treatment · 2022Article
- Bimodal Age Distribution in Cancer Incidence.World journal of oncology · 2022Review
- Spatial Characterization of Tumor-Infiltrating Lymphocytes and Breast Cancer Progression.Cancers · 2022Article
- Postpartum breast cancer has a distinct molecular profile that predicts poor outcomes.Nature communications · 2021Article
- Epidemiology of Basal-like and Luminal Breast Cancers among Black Women in the AMBER Consortium.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2021Article
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Abstract
purposeFemale breast cancer demonstrates bimodal age frequency distribution patterns at diagnosis, interpretable as two main etiologic subtypes or groupings of tumors with shared risk factors. While RNA-based methods including PAM50 have identified well-established clinical subtypes, age distribution patterns at diagnosis as a proxy for etiologic subtype are not established for molecular and genomic tumor classifications.
methodsWe evaluated smoothed age frequency distributions at diagnosis for Carolina Breast Cancer Study cases within immunohistochemistry-based and RNA-based expression categories. Akaike information criterion (AIC) values compared the fit of single density versus two-component mixture models. Two-component mixture models estimated the proportion of early-onset and late-onset categories by immunohistochemistry-based ER (n = 2860), and by RNA-based ESR1 and PAM50 subtype (n = 1965). PAM50 findings were validated using pooled publicly available data (n = 8103).
resultsBreast cancers were best characterized by bimodal age distribution at diagnosis with incidence peaks near 45 and 65 years, regardless of molecular characteristics. However, proportional composition of early-onset and late-onset age distributions varied by molecular and genomic characteristics. Higher ER-protein and ESR1-RNA categories showed a greater proportion of late age-at-onset. Similarly, PAM50 subtypes showed a shifting age-at-onset distribution, with most pronounced early-onset and late-onset peaks found in Basal-like and Luminal A, respectively.
conclusionsBimodal age distribution at diagnosis was detected in the Carolina Breast Cancer Study, similar to national cancer registry data. Our data support two fundamental age-defined etiologic breast cancer subtypes that persist across molecular and genomic characteristics. Better criteria to distinguish etiologic subtypes could improve understanding of breast cancer etiology and contribute to prevention efforts.
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