Abstract
Abstract
Evaluating breast cancer mortality by estrogen receptor (ER) status can help inform strategies to reduce the U.S. breast cancer burden. We used SEER 17 registries to calculate age-standardized breast cancer incidence-based mortality (IBM) rates per 100,000 person-years from 2009–2022 by ER status (positive/negative) and compared with incidence and 5-year relative survival. We estimated trends using average annual percent change (AAPC). For ER-positive breast cancers, IBM rates marginally increased from 2009 (16.6) to 2014 (17.2) and then decreased by 2022 (15.2) (AAPC:2009-2022=-0.65%,95%CI=-1.35%,0.05%;AAPC:2014-2022=-1.53%,95%CI=-1.88%,-1.19%). Incidence rates decreased then increased again, with small increases in survival. For ER-negative breast cancers, IBM rates decreased significantly (2009=9.6,2022=6.4;AAPC=-3.33%,95%CI=-4.17%,-2.48%) in parallel with declining incidence rates and significant survival improvements. In 2022, ER-positive breast cancers accounted for 5-times more cases and 2-times more deaths than ER-negative; despite effective therapies, ER-positive mortality did not have substantial declines, indicating public health opportunities to reduce the population burden of breast cancer mortality.