Comparison of Clinicopathological Features and Treatments between Young (≤40 Years) and Older (>40 Years) Female Breast Cancer Patients in West China: A Retrospective, Epidemiological, Multicenter, Case Only Study
March
Comparison of Clinicopathological Features and Treatments between Young ( 40 Years) and Older (>40 Years) Female Breast Cancer Patients in West China: A Retrospective, Epidemiological, Multicenter, Case Only Study
Ke Wang 0
Yu Ren 0
Hongyuan Li
Ke Zheng
Jun Jiang
Tianning Zou
Binlin Ma
Hui Li
Qilun Liu
Jianghua Ou
Ling Wang
Wei Wei
Jianjun He 0
Guosheng Ren
Yves St-Pierre, INRS, CANADA
0 0 Department of Breast Surgery, Cancer Hospital of Guangxi Medical University , Nanning, Guangxi Province , China
The incidence of young cases of breast cancer is higher in China compared to the western world. We aimed to explore differences in risk factors, clinicopathological features and treatment modes of young female breast cancer compared to older patients in West China. We collected clinical information from 12,209 female breast cancer patients in West China, including risk factors, clinicopathological features and treatment modes, from January 2010 to December 2012. Chi-square tests and the multivariate logistic regression analysis were applied for statistical analysis. There were 2,682 young ( 40 years) cases and 9,527 older cases at the time of breast cancer diagnosis. Young patients had a greater tumor diameter at diagnosis, and a higher probability of axillary lymph node and distant metastasis (P < 0.05). The progesterone receptor positive expression rate, estrogen receptor/progesterone receptor double positive expression rate, and human epidermal growth factor receptor 2 (HER2) negative expression rate was higher in young patients compared to older patients (P < 0.05). For young patients, the age at menarche was earlier, they had lower marriage rates, fewer pregnancies and births, and a lower breastfeeding rate (P < 0.05). A higher proportion of young patients underwent advanced operations, neoadjuvant and adjuvant
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OPEN ACCESS
Data Availability Statement: All relevant data are
within the paper and its Supporting Information file.
Funding: The authors received no specific funding
for this work.
Competing Interests: The authors have declared
that no competing interests exist.
Abbreviations: ER, estrogen receptor; PR,
progesterone receptor; HER2, human epidermal
growth factor receptor 2; T, taxol.
chemotherapy, radiotherapy, and endocrine therapy compared to older patients (P < 0.05).
We found significant differences in the clinicopathological features, risk factors and
treatment modes between young ( 40 years) and older (>40 years) female breast cancer
patients in West China. As some of these results differ from those found in the western
female population, it is likely that the mechanism of tumorigenesis of young female breast
cancer patients in West China may differ from that in western developed countries. Further
investigation into the regional differences in breast cancer tumorigenesis is warranted.
Introduction
Differences in the clinical and biological characteristics between young and older breast cancer
patients have been observed. Breast cancer in young patients is often more malignant, at a later
tumor stage with higher tumor grade, has a larger tumor size, and there are more cases that are
also lymph node positive compared to older patients [
1–3
]. Therefore, different treatment
strategies should be adopted to treat young and older breast cancer patients, respectively.
In recent years, the incidence of breast cancer has leaped to the number one female cancer
in China. In 2010, the crude incidence rate of female breast cancer patients were 32.43 per
100,000 and the estimated number of death was about 55,500 in China.[
4
] Several studies have
shown that young patients ( 40 years) accounted for about 20% of the total breast cancer
cases in China [
5, 6
], which is significantly higher than that of western population (i.e., around
5%) [
7, 8
]. This suggests the possibility that certain differences in the pathogenesis of breast
cancer may exist between young Chinese women and women in the western population.
Despite the large number of cases of young female breast cancer ( 40 years) in China, few
multicenter studies have been performed correlating onset age with clinicopathological features
and treatment mode. This study aimed to retrospectively investigate the morbidity of female
breast cancer in nine provinces of West China, and compare the differences in
clinicopathological features and treatment options between young and older female breast cancer patients. The
results of this study will provide new reference data for developing more suitable clinical
diagnosis and treatment strategies for female breast cancer in West China. In addition, as West
China is typical of a developing economic region, our results may also provide reference data
for new diagnosis and treatment strategies for breast cancer in other developing countries.
Methods
Study design
The Western China Clinical Cooperation Group (WCCCG) was established in 2008 and
includes 23 breast cancer centers from ni (...truncated)