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

Abstract

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 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.

Comparison of epidemiological features, clinicopathological features, and treatments between premenopausal and postmenopausal female breast cancer patients in western China: a retrospective multicenter study of 15,389 female patients

“…We obtained similar results. Those results are similar to that in another article from the same database 32. Additionally, higher proportion of (ER+/PR+) in premenopausal patients and higher proportion of (ER−/PR−) in postmenopausal patients suggested that the distribution of hormone receptors in western Chinese women is different from that in foreign countries.…”

“…Breast cancer is age‐dependent, and it is widely accepted that young women tend to present with a greater tumor size that is more advanced and with poorer prognostic characteristics 31, 32. We found that premenopausal women presented with a greater tumor size (more than 2 cm) than postmenopausal women in our study.…”

“…Chemotherapy is one of the most commonly used and most effective methods among adjuvant therapies for treating breast cancer. Premenopausal patients had a smaller average age, higher malignancy, and risk of recurrence of the tumors 32, and it was reported that chemotherapy can significantly reduce the risk of relapse of high malignant breast cancer 34, 40, so they could benefit more from chemotherapy. The discovery of more aggressive cancers found in premenopausal women is the fact that leads to more chemotherapy in this population.…”

Present and changing trends in surgical modalities and neoadjuvant chemotherapy administration for female breast cancer in Beijing, China: A 10‐year (2006–2015) retrospective hospitalization summary report‐based study

“…The proportion of patients who underwent surgery in the present study was 86.84%, lower than in the previous study. This difference is primarily because the previous study only included one or two hospitals in each city, while the patients in our study may have undergone surgery in one hospital but were treated in several others . The influence of age on the choice of treatment modes has been discussed by previous studies.…”

Effect of younger age on survival outcomes in T1N0M0 breast cancer: A propensity score matching analysis

“…Hanrahan et al reported the median age at diagnosis of early‐stage BC to be 65 years among 51 246 patients in the SEER database, compared with a median age of 49 years in a study of 868 Chinese women with stage I‐III BC . Second, the percentage of patients with BC who are younger than 40 years old in Western countries is only 5% to 9.6%, compared with approximately 20% in Asian countries …”