Breast Cancer in Turkey: Clinical and Histopathological Characteristics (Analysis of 13.240 Patients)

Abstract

Objective: Breast cancer is the most common type of cancer and the leading cause of cancer related deaths in women in Turkey, as elsewhere around the world. However, detailed and systematic demographics, data on clinical and pathological characteristics, and treatment were largely unavailable in Turkey until now. This paper is intended to provide an analysis of clinical and pathological data on women registered in the National Breast Cancer Database (Ulusal Meme Kanseri Veri Tabanı Results: A total of 13,240 patients with breast cancer since April 07, 1992 were included in the study, and 99% of them were female. Female breast cancer patients whose requisite parameters had been completely entered in the database were included in the analysis. The mean age was 51.6 years (±12.6; range 12-97), 17% of them were younger than 40 years of age, and 45% were premenopausal. According to an analysis of age groups at diagnosis, the frequency of cancer peaked at the 45 -49 age group with 16.7%, declining to 7.6% in the 65-69 age group, and then rose again. Most of the patients (78.7%) had invasive ductal, 7.8% were invasive lobular cancers, 9.8% were invasive mixed cancers (invasive ductal + invasive lobular), and 4% were other histological types (e.g. inflammatory, intracystic papillary, mucinous, etc.), respectively. Half of them (50%) had grade III histology. According to an analysis of pathological stages of all breast cancers (stage 0 -IV), 5% were stage 0, 27% were stage I, 44% were stage II, 21% were stage III, and 3% were stage IV breast cancer, respectively. The mean tumor diameter was 2.5 cm (±1.6; range 0.1-20 cm). The rates of lymphatic stages were pN0 50%, pN1 28%, pN2 15%, and pN3 7%, respectively. ER, PR, and HER-2 receptors were positive in 70%, 59%, and 23% of patients. A subtype analysis of tumors showed that 62% were type luminal A. This was followed by subtypes luminal B (15%), triple negative (15%), and HER-2 positive (8.5%). Conclusion:As a conclusion patients with breast cancer in our breast cancer registry program were younger, and had more advanced disease, and worse prognostic factors than patients in developed countries.

Controversies on Mammography Screening in the World and Bahceşehir Population-Based Organized Mammography Screening Project in Turkey

“…The rates of DCIS and stage I breast cancers detected in this program were similar to the rates in western societies where screening is performed regularly, which suggests that population-based screening could be implemented in our country. A comparison of patients who were diagnosed as having breast cancer in the Bahçeşehir program with those in the Turkish Federation of Breast Diseases Societies (TFBDS) Breast Cancer Registry Program revealed that mammography screening increased life expectancy to a mean of 5.84 years in each patient diagnosed in this program (15). The Cancer Control Department of Turkish Ministry of Health decided to lower the age for initiating screening for breast cancer from 50 years to 40 years because half of the women with breast cancer both in our screening program and breast cancer registry program were aged under 50 years.…”

“…In this analysis, the expenses on screening and treatment of patients who were 153 Özmen V. Screening mammography update diagnosed as having breast cancer using screening (asymptomatic patients) were compared with the treatment expenses of patients in the TFBDS Breast Cancer Registry Program (symptomatic patients) (15). The number of women who participated in the third screening period was 7167, and the number of asymptomatic patients who were diagnosed as having breast cancer was 67.…”

Role Of Environmental Carcinogens in The Etiology Of Breast Cancer

“…Asya, Ortadoğu ve Afrika'daki gelişmekte olan ülkelerde ise düşük insidans gözlenmektedir. 2,3 Türkiye'de ise, meme kanseri insidansının arttığı ve 2007 yılında belirlenmiş meme kanseri vaka sayısının 44.253 olduğu bildirilmiştir. Ayrıca Türkiye'nin farklı bölgelerinde meme kanseri insidansı-nın çeşitlilik gösterdiği bildirilmiştir.…”

Cost-Effectiveness of Breast Cancer Screening in Turkey, a Developing Country: Results from Bahçeşehir Mammography Screening Project

“…mammography is offered to a woman without symptoms of breast cancer who visits a clinic for unrelated reasons) free of charge (8,9). Furthermore, TMOH published the first population-based mammography screening guidelines in 2004, which recommended biennial screening for women between 50 and 69 years of age.…”

“…For example, the distribution of breast density, a significant breast cancer risk factor also affecting the performance of mammography, is significantly different in Turkey than that in the US and Europe (14). Furthermore, almost 50% of all invasive breast cancers in Turkey are diagnosed in women younger than 50 years of age whereas only 25% of all invasive breast cancers are diagnosed in the same age group in the US (8,15).…”