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Stage IV Breast Cancer Incidence and Survival, 2010-2021
Jorge Avila1, Julieta Leone2, Nabihah Tayob3,4
1Department of Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
JAMA Network Open
|May 12, 2026
Summary
The incidence of de novo stage IV breast cancer has increased significantly from 2010-2021, affecting all demographics and tumor subtypes. While overall survival has improved, further research is needed to understand the rising incidence rates.
Area of Science:
- Oncology
- Epidemiology
- Public Health
Background:
- Trends in de novo stage IV breast cancer incidence and survival rates are not well-documented.
- Understanding these trends is crucial for public health strategies and patient care.
Purpose of the Study:
- To evaluate the incidence, percentage, and survival of patients diagnosed with de novo stage IV breast cancer between 2010 and 2021.
- To analyze trends across different tumor subtypes, age groups, and sexes.
Main Methods:
- A population-based cohort study utilizing data from the Surveillance, Epidemiology, and End Results (SEER) program.
- Analysis of age-adjusted incidence rates, annual percentage changes (APC), and overall survival (OS) using multivariable Cox proportional hazards regression models.
- Inclusion of all individuals diagnosed with de novo invasive breast cancer from January 1, 2010, to December 31, 2021, with no exclusion criteria.
Main Results:
- Stage IV breast cancer incidence increased from 9.5 to 11.2 cases per 100,000 females (APC 1.2%) between 2010 and 2021.
- Incidence of stage IV disease rose across all tumor subtypes, ages, and both sexes, including a significant increase in males (APC 3.7%).
- The percentage of stage IV diagnoses increased significantly for all tumor subtypes, and overall survival (OS) improved annually for most subtypes.
Conclusions:
- De novo stage IV breast cancer incidence has significantly increased across all demographics and tumor subtypes from 2010-2021.
- Despite improved survival, the rising incidence warrants further investigation into contributing factors like screening, natural history, and comorbidities.
- These findings highlight the need for continued research and potential adjustments in breast cancer management and public health initiatives.
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